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MODERN HEALTH LLC NPI 1275231276


NPI Information

NPI: 1275231276
Provider Name: MODERN HEALTH LLC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2285379

Address:
2440 HIGHVIEW ST
SPRING GROVE, IL
ZIP 60081
Phone: (815) 900-7330
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MODERN HEALTH LLC is a family medicine in Spring Grove, 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. MODERN HEALTH LLC NPI is 1275231276. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

2440 HIGHVIEW ST
SPRING GROVE, IL
ZIP 60081-609
Phone: (815) 900-7330
Fax: (928) 268-0163

The provider's authorized official is Nicole J Hendrickson .
The authorized official title is Aprn and has the following contact phone number (847) 417-7987.

The CLIA number assigned to this NPI record is 14D2285379 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/20/2023 and was last updated on 4/3/2023.


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
1207QA0401XFamily MedicineAddiction MedicineNo
2363LC1500XNurse PractitionerCommunity HealthNo
3363LF0000XNurse PractitionerFamilyNo
4363LP0808XNurse PractitionerPsychiatric/Mental HealthNo
5207Q00000XFamily 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: 5/5/2024

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