ULTRAMED PRIMARY CARE LTD NPI 1083103709

NPI Information

NPI: 1083103709
Provider Name: ULTRAMED PRIMARY CARE LTD
Classification: Clinic/Center - 261QP2300X
Entity Type: Organization

Specialization: Primary Care

CLIA Number: 14D2128305

Address:
5020 DEMPSTER ST
SKOKIE, IL
ZIP 60077
Phone: (847) 423-2264
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ULTRAMED PRIMARY CARE LTD is a primary care clinic center in Skokie, IL. ULTRAMED PRIMARY CARE LTD NPI is 1083103709. The provider is registered as an organization entity type.

The provider's business location address is:

5020 DEMPSTER ST
SKOKIE, IL
ZIP 60077-835
Phone: (847) 423-2264

The provider's authorized official is Holly Hosey .
The authorized official title is Office Manager and has the following contact phone number (847) 423-2264.

The CLIA number assigned to this NPI record is 14D2128305 - other with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 5/8/2018 and was last updated on 5/8/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QP2300X	Clinic/Center	Primary Care			Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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