OUR MEDICAL CENTER LLC NPI 1316439722

NPI Information

  • NPI: 1316439722
  • Provider Name: OUR MEDICAL CENTER LLC
  • Classification: Nurse Practitioner - 363LP0808X
  • Specialization: Psychiatric/Mental Health
  • Entity Type: Organization
  • Address: 451 DUNHAM RD STE 300
    SAINT CHARLES, IL
    ZIP 60174
  • Phone: (630) 521-3110

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NPI Details

OUR MEDICAL CENTER LLC is a psychiatric/mental health nurse practitioner in Saint Charles, IL. OUR MEDICAL CENTER LLC NPI is 1316439722. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

451 DUNHAM RD STE 300
SAINT CHARLES, IL
ZIP 60174-431
Phone: (630) 521-3110
Fax: (630) 296-8965

The provider's authorized official is Cecilia Berumen .
The authorized official title is Nurse Practitioner / Psych and has the following contact phone number (630) 521-3110.

The enumeration date for this NPI number is 5/31/2018 and was last updated on 7/8/2021.

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
1363LP0808XNurse PractitionerPsychiatric/Mental Health209013778ILLINOISYes
2363LP2300XNurse PractitionerPrimary Care209013778ILLINOISNo

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
11437547858OTHERILLINOISBLUE CROSS BLUE SHIELD

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: 11/21/2025

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