Provider Type Icon

MYCARE EXPRESS CARE INC NPI 1396464657


NPI Information

NPI: 1396464657
Provider Name: MYCARE EXPRESS CARE INC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 14D2266349

Address:
1404 EASTLAND DR STE 103
BLOOMINGTON, IL
ZIP 61701
Phone: (093) 192-3933
Get Directions

MYCARE EXPRESS CARE INC is a specialist in Bloomington, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. MYCARE EXPRESS CARE INC NPI is 1396464657. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1404 EASTLAND DR STE 103
BLOOMINGTON, IL
ZIP 61701-904
Phone: (093) 192-3933

The provider's authorized official is Jibran Naseer .
The authorized official title is Owner and has the following contact phone number (309) 319-2393.

The CLIA number assigned to this NPI record is 14D2266349 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/22/2022 and was last updated on 10/28/2022.


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
1207Q00000XFamily MedicineNo
2174400000XSpecialistYes

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.