PURE MEDICAL GROUP LLC NPI 1912621491

NPI Information

NPI: 1912621491
Provider Name: PURE MEDICAL GROUP LLC
Classification: Clinic/Center - 261QM0850X
Entity Type: Organization

Specialization: Adult Mental Health

Address:
343 N WOOD DALE RD STE 201
WOOD DALE, IL
ZIP 60191
Phone: (773) 817-5928
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PURE MEDICAL GROUP LLC is an adult mental health clinic center in Wood Dale, IL. The provider is an entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to mental and behavioral disorders in adults. PURE MEDICAL GROUP LLC NPI is 1912621491. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

343 N WOOD DALE RD STE 201
WOOD DALE, IL
ZIP 60191-565
Phone: (773) 817-5928

The provider's authorized official is Wajahatuddin Macci .
The authorized official title is Cfo and has the following contact phone number (773) 817-5928.

The enumeration date for this NPI number is 9/28/2022 and was last updated on 9/29/2022.

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	Primary
1	101Y00000X	Counselor		No
2	103K00000X	Behavior Analyst		No
3	251300000X	Local Education Agency (LEA)		No
4	261QM0855X	Clinic/Center	Adolescent and Children Mental Health	No
5	261QM0850X	Clinic/Center	Adult Mental Health	Yes

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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