PRESENCE HEALTHCARE SERVICES NPI 1093780181

NPI Information

  • NPI: 1093780181
  • Provider Name: PRESENCE HEALTHCARE SERVICES
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • Doing Business As: PRESENCE MEDICAL GROUP
  • Address: 5600 W ADDISON ST
    SUITE 301
    CHICAGO, IL
    ZIP 60634
  • Phone: (773) 736-4553

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NPI Details

PRESENCE HEALTHCARE SERVICES is a primary care clinic center in Chicago, IL. PRESENCE HEALTHCARE SERVICES NPI is 1093780181. The provider is registered as an organization entity type.
The provider Is Doing Business As Presence Medical Group.

The provider's business location address is:

5600 W ADDISON ST
SUITE 301
CHICAGO, IL
ZIP 60634-401
Phone: (773) 736-4553
Fax: (773) 205-1997

The provider's authorized official is Melvonne Wickliffe-jones .
The authorized official title is Credentialing Mgr and has the following contact phone number (630) 914-2417.

The enumeration date for this NPI number is 2/22/2006 and was last updated on 4/10/2013.

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
1261QP2300XClinic/CenterPrimary CareYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1261840MEDICARE ID-TYPE UNSPECIFIEDILLINOIS
2745367MEDICARE PIN
3C31016MEDICARE UPINILLINOIS
4036067614MEDICAIDILLINOIS

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: 3/30/2025

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