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PURE HEALTH PHYSICAL MEDICINE LLC NPI 1134466162


NPI Information

NPI: 1134466162
Provider Name: PURE HEALTH PHYSICAL MEDICINE, LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
2116 W GALENA BLVD
SUITE 112
AURORA, IL
ZIP 60506
Phone: (630) 897-1895
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PURE HEALTH PHYSICAL MEDICINE, LLC is a family medicine in Aurora, 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. PURE HEALTH PHYSICAL MEDICINE, LLC NPI is 1134466162. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2116 W GALENA BLVD
SUITE 112
AURORA, IL
ZIP 60506-533
Phone: (630) 897-1895

The provider's authorized official is Kenneth Olson .
The authorized official title is Owner and has the following contact phone number (630) 897-1895.

The enumeration date for this NPI number is 1/10/2013 and was last updated on 10/3/2013.


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 CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1111N00000XChiropractor038008765ILLINOISNo
2111N00000XChiropractor038011191ILLINOISNo
3111N00000XChiropractor038011696ILLINOISNo
4363LF0000XNurse PractitionerFamily209010369ILLINOISNo
5207Q00000XFamily Medicine036099986ILLINOISYes

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 IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1IL8252OTHERILLINOISMEDICARE PTAN

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.