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A & S DIVINE HEALTHCARE SERVICES PLLC NPI 1215519038


NPI Information

NPI: 1215519038
Provider Name: A & S DIVINE HEALTHCARE SERVICES PLLC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

CLIA Number: 14D2222293

Address:
1477 RING RD
CALUMET CITY, IL
ZIP 60409
Phone: (708) 933-6346
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A & S DIVINE HEALTHCARE SERVICES PLLC is a family nurse practitioner in Calumet City, IL. A & S DIVINE HEALTHCARE SERVICES PLLC NPI is 1215519038. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1477 RING RD
CALUMET CITY, IL
ZIP 60409-459
Phone: (708) 933-6346
Fax: (708) 933-6356

The provider's authorized official is Angel White .
The authorized official title is Co-owner/family Nurse Practitioner and has the following contact phone number (708) 933-6346.

The CLIA number assigned to this NPI record is 14D2222293 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 4/21/2021 and was last updated on 11/16/2021.


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
1363LF0000XNurse PractitionerFamilyYes

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: 5/5/2024

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.