PRIMARY CARE PHYSICIANS OF JOLIET SC NPI 1912473604

NPI Information

  • NPI: 1912473604
  • Provider Name: PRIMARY CARE PHYSICIANS OF JOLIET SC
  • Classification: Clinic/Center - 261QP2300X
  • Specialization: Primary Care
  • Entity Type: Organization
  • CLIA Number: 14D1018476
  • Address: 2025 S CHICAGO ST STE 1
    JOLIET, IL
    ZIP 60436
  • Phone: (815) 726-2200

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NPI Details

PRIMARY CARE PHYSICIANS OF JOLIET SC is a primary care clinic center in Joliet, IL. PRIMARY CARE PHYSICIANS OF JOLIET SC NPI is 1912473604. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

2025 S CHICAGO ST STE 1
JOLIET, IL
ZIP 60436-173
Phone: (815) 726-2200

The provider's authorized official is Miti G Shah .
The authorized official title is Practice Manager and has the following contact phone number (815) 726-2200.

The CLIA number assigned to this NPI record is 14D1018476 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 10/19/2018 and was last updated on 10/19/2018.

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
2207R00000XInternal MedicineNo
3261QP2300XClinic/CenterPrimary CareYes

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: 3/30/2025

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