Provider Type Icon

PRIMARY CARE SPECIALISTS LLC NPI 1154556843


NPI Information

NPI: 1154556843
Provider Name: PRIMARY CARE SPECIALISTS, LLC
Classification: Internal Medicine - 207RG0300X
Entity Type: Organization

Specialization: Geriatric Medicine

Address:
2 AIRLINE DR
SUITE 500
BLOOMINGTON, IL
ZIP 61704
Phone: (636) 579-6778
Get Directions

PRIMARY CARE SPECIALISTS, LLC is a geriatric medicine internal medicine in Bloomington, IL. The provider is an internist who has special knowledge of the aging process and special skills in the diagnostic, therapeutic, preventive and rehabilitative aspects of illness in the elderly. This specialist cares for geriatric patients in the patient's home, the office, long-term care settings such as nursing homes and the hospital. PRIMARY CARE SPECIALISTS, LLC NPI is 1154556843. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2 AIRLINE DR
SUITE 500
BLOOMINGTON, IL
ZIP 61704-433
Phone: (636) 579-6778

The provider's authorized official is Srivalli Vegi .
The authorized official title is Owner and has the following contact phone number (636) 579-6778.

The enumeration date for this NPI number is 5/25/2009 and was last updated on 4/15/2010.


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
1207R00000XInternal Medicine036121501ILLINOISNo
2207RG0300XInternal MedicineGeriatric Medicine036121501ILLINOISYes

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
1IL2503MEDICARE PINILLINOIS

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.