PARK AVENUE PRIVATE PRACTICE LLC NPI 1851763213

NPI Information

  • NPI: 1851763213
  • Provider Name: PARK AVENUE PRIVATE PRACTICE LLC
  • Classification: Clinic/Center - 261QH0100X
  • Specialization: Health Service
  • Entity Type: Organization
  • CLIA Number: 14D1047511
  • Address: 767 PARK AVE W STE 350
    HIGHLAND PARK, IL
    ZIP 60035
  • Phone: (847) 433-5505

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NPI Details

PARK AVENUE PRIVATE PRACTICE LLC is a health service clinic center in Highland Park, IL. PARK AVENUE PRIVATE PRACTICE LLC NPI is 1851763213. The provider is registered as an organization entity type.

The provider's business location address is:

767 PARK AVE W STE 350
HIGHLAND PARK, IL
ZIP 60035-472
Phone: (847) 433-5505
Fax: (847) 433-5510

The provider's authorized official is Jeffrey S Garland .
The authorized official title is President, Medical Doctor and has the following contact phone number (847) 433-5505.

The CLIA number assigned to this NPI record is 14D1047511 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/26/2015 and was last updated on 2/2/2016.

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
1261QH0100XClinic/CenterHealth Service248.001237ILLINOISYes

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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