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TRI CARE MEDICAL GROUP LLC NPI 1598081333


NPI Information

NPI: 1598081333
Provider Name: TRI CARE MEDICAL GROUP LLC

Doing Business As: NORTHWEST IMMEDIATE CARE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2289920

Address:
4332 N ELSTON AVE
CHICAGO, IL
ZIP 60641
Phone: (847) 891-6850
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TRI CARE MEDICAL GROUP LLC is a family medicine in Chicago, 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. TRI CARE MEDICAL GROUP LLC NPI is 1598081333. The provider is registered as an organization entity type.
The provider Is Doing Business As Northwest Immediate Care.

The provider's business location address is:

4332 N ELSTON AVE
CHICAGO, IL
ZIP 60641-144
Phone: (847) 891-6850
Fax: (630) 339-5803

The provider's authorized official is Mohammad Azharuddin .
The authorized official title is President and has the following contact phone number (847) 891-6850.

The CLIA number assigned to this NPI record is 14D2289920 - ancillary testing site in health care center with a certificate type of Certificate of Accreditation.

The enumeration date for this NPI number is 4/19/2010 and was last updated on 4/20/2010.


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
1261QU0200XClinic/CenterUrgent CareNo
2207Q00000XFamily MedicineYes

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: 4/28/2024

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