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MY FAMILY DOC LLC NPI 1528489739


NPI Information

NPI: 1528489739
Provider Name: MY FAMILY DOC LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2073240

Address:
2001-03 ESSINGTON RD
JOLIET, IL
ZIP 60435
Phone: (815) 733-6888
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MY FAMILY DOC LLC is a family medicine in Joliet, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MY FAMILY DOC LLC NPI is 1528489739. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

2001-03 ESSINGTON RD
JOLIET, IL
ZIP 60435
Phone: (815) 733-6888
Fax: (815) 733-6890

The provider's authorized official is Molly D'costa .
The authorized official title is Owner, Physician and has the following contact phone number (815) 733-6888.

The CLIA number assigned to this NPI record is 14D2073240 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 12/16/2013 and was last updated on 11/3/2023.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily Medicine036116813ILLINOISYes

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: 4/28/2024

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