PREMIER MEDICAL CARE ADDISON, LTD (NPI# 1588972616) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588972616 |
| Entity Type | Organization |
| Organization Name | PREMIER MEDICAL CARE ADDISON, LTD |
| Other Organization Name | PREMIER OCCUPATIONAL |
| Practice Address |
1415 W Lake St Addison IL 60101-1870 |
| Practice Telephone | 6307051630 |
| Practice Fax Number | 6307051692 |
| Mailing Telephone | 6307051630 |
| Mailing Fax Number | 6307051692 |
| Enumeration Date | 2010-09-23 |
| Last Update Date | 2010-09-23 |
| Authorized Official Name | ANATOLY GOROVITS (PRESIDENT) |
| Authorized Official Telephone | 6307051630 |
| Authorized Official Credential | M.D. |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | 036113828 | IL | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Premier Occupational | Doing Business As Name - Organization |
| Street Address |
1415 W LAKE ST |
| City | ADDISON |
| State | IL |
| Zip Code | 60101-1870 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174551162 | Marzena D Kaniuk | Physical Therapist | 1415 W Lake St, Addison, IL 60101 | 2006-06-29 |
| 1427241884 | Paulina Lowkis | Dietitian, Registered | 1415 W Lake St, Addison, IL 60101-1870 | 2007-08-20 |
| 1174729487 | Mike J Hickey | Specialist/Technologist | 1415 W Lake St, Addison, IL 60101-1870 | 2007-06-23 |
| 1881626570 | Charles Baum | Internal Medicine | 1415 W Lake St, Addison, IL 60101-1870 | 2006-07-06 |
| 1013946896 | Sheila Dowd | Psychologist | 1415 W Lake St, Addison, IL 60101-1870 | 2006-07-02 |
| 1376571026 | Renato M Arias | Family Medicine | 1415 W Lake St, Addison, IL 60101-1870 | 2006-06-30 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1912445800 | Allure Skin and Laser | Nurse Practitioner | 240 E Lake Street, Addison, IL 60101 | 2017-02-10 |
| 1912444662 | Iulia Kaulinite | Registered Nurse | 1845 East Army Trail Road, Addison, IL 60101 | 2017-01-19 |
| 1164891727 | Sonic Imaging Inc | Clinic/Center | 4n277 9th Ave, Addison, IL 60101 | 2015-09-24 |
| 1881001147 | Evelina Rodriguez | Interpreter | 102 S. Grant Drive, Addison, IL 60101 | 2014-07-18 |
| 1821426867 | Carrie Lyne M Mathiesen | Physical Medicine & Rehabilitation | 2375 S. Randall Rd, Algonquin, IL 60101 | 2013-10-30 |
| 1972949634 | Vascular Diagnostic LLC | Clinic/Center | 2166, W Silverleaf Ln, Addison, IL 60101 | 2013-05-21 |
| 1134401409 | Colleen Ann O'brien | Occupational Therapist | 222 North Kennedy Dr., Addison, IL 60101 | 2011-09-13 |
| 1962700096 | Pharma Medical Supply Inc | Durable Medical Equipment & Medical Supplies | 970 Lake St Suite 109, Roselle, IL 60101 | 2011-03-15 |
| 1235372947 | Nancy M Ngo | Dentist | 200 W. Lake Street, Addison, IL 60101 | 2009-04-10 |
| 1326288275 | Familia Dental | Dentist | 200 West Lake Street, Addison, IL 60101 | 2009-03-04 |
| Find all providers in zip 60101 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932596004 | Ahr Medical Group Pa | General Practice | 4101 Centurion Way, Addison, TX 75001-4347 | 2015-04-16 |
| 1710268305 | American Visiting Doctors LLC | General Practice | 14232 Marsh Ln, #472, Addison, TX 75001-3857 | 2011-09-09 |
| 1467564294 | R Castillo Md and L Ramos-castillo Md Sc | General Practice | 21w480 Army Trail Rd, Addison, IL 60101-1404 | 2006-08-31 |
| 1083614358 | Julie Lynn Reihsen | General Practice | 16901 Dallas Pkwy, Ste 208, Addison, TX 75001-5226 | 2005-07-28 |
| 1962740480 | Healthy Connection Physical Medicine Addison | General Practice | 190 N Swift Rd, Addison, IL 60101-1476 | 2013-01-17 |
| 1356588339 | Concentra Akron LLC | General Practice | 5080 Spectrum Dr, Suite 1200 West, Addison, TX 75001-4625 | 2009-01-13 |
| 1629245030 | Julie L. Reihsen M.d./pa | General Practice | 16901 Dallas Pkwy, Ste 208, Addison, TX 75001-5226 | 2008-05-14 |
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| 1306465786 | Brightlife Regenerative Medical Clinic Lombard Sc | General Practice | 442 E Roosevelt Rd, Lombard, IL 60148-4630 | 2020-04-15 |
| 1851920524 | Sahens Mezidor | General Practice | 228 Ridge Ave Apt G, Evanston, IL 60202-6409 | 2020-04-05 |
| 1447881487 | Tyrian Healthcare Solutions, LLC | General Practice | 2120 W Heading Ave, West Peoria, IL 61604-5138 | 2020-01-29 |
| 1598302077 | Enhance Medical LLC | General Practice | 1193 N Gary Ave, Carol Stream, IL 60188-9423 | 2019-12-04 |
| 1164067054 | League Corp. | General Practice | 515 N State St Fl 8, Chicago, IL 60654-9102 | 2019-11-14 |
| 1679129977 | Chronic Care Solutions LLC | General Practice | 3050 W Columbia Ave, Chicago, IL 60645-4006 | 2019-08-13 |
| 1205393972 | Midwest Medical LLC | General Practice | 2001 Midwest Rd Ste Ll22, Oak Brook, IL 60523-1316 | 2019-02-28 |
| 1306311725 | Genesis Integrative Medicine LLC | General Practice | 1881 S Randall Rd Ste C, Geneva, IL 60134-2532 | 2018-10-11 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.