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SUBURBAN MEDICAL GROUP LLC NPI 1518380633


NPI Information

NPI: 1518380633
Provider Name: SUBURBAN MEDICAL GROUP, LLC
Classification: Specialist - 174400000X
Entity Type: Organization

CLIA Number: 14D2214050

Address:
1600 DEMPSTER ST
SUITE 103
PARK RIDGE, IL
ZIP 60068
Phone: (847) 296-9040
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SUBURBAN MEDICAL GROUP, LLC is a specialist in Park Ridge, 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. SUBURBAN MEDICAL GROUP, LLC NPI is 1518380633. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

1600 DEMPSTER ST
SUITE 103
PARK RIDGE, IL
ZIP 60068-109
Phone: (847) 296-9040
Fax: (847) 296-9050

The provider's authorized official is Pritesh Patel .
The authorized official title is Owner and has the following contact phone number (847) 296-9040.

The CLIA number assigned to this NPI record is 14D2214050 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/24/2014 and was last updated on 1/24/2014.


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
1174400000XSpecialist056.006288ILLINOISYes

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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