SOLID ROCK CARE CENTER II NPI 1780877993

NPI Information

NPI: 1780877993
Provider Name: SOLID ROCK CARE CENTER II
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
228 MADISON ST
OAK PARK, IL
ZIP 60302
Phone: (708) 358-8040
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SOLID ROCK CARE CENTER II is a general practice in Oak Park, IL. The provider is a physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee SOLID ROCK CARE CENTER II NPI is 1780877993. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

228 MADISON ST
OAK PARK, IL
ZIP 60302-194
Phone: (708) 358-8040
Fax: (708) 358-8049

The provider's authorized official is Larry Smith .
The authorized official title is Ceo and has the following contact phone number (708) 358-8040.

The enumeration date for this NPI number is 8/21/2007 and was last updated on 8/13/2008.

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
1	208D00000X	General Practice				Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	211006	MEDICARE PIN	ILLINOIS
2	6030201	MEDICAID	ILLINOIS
3	=========6030201	MEDICAID	ILLINOIS

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

NPI Synchronization or Removal

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