Premier Primary Care And Alternative Medicine
Internal Medicine in Chicago, IL. Organization (NPI-2).
NPI number1003406000
StatusActive
Last updated in NPPESJun 28, 2021
Details
- NPI
- 1003406000
- Entity type
- Organization (NPI-2)
- Legal business name
- Premier Primary Care And Alternative Medicine
- Organization subpart
- Yes
- Enumeration date
- Jan 22, 2021
- Certification date
- Jun 28, 2021
- Last updated
- Jun 28, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207R00000X | Internal Medicine | – | – | Yes |
| 207Q00000X | Family Medicine | – | – |
Practice location
1301 E 47th StreetBldg 2 Suite B
Chicago, IL 60653
Phone 773-891-2890 · Fax 773-891-4107
Mailing address
1301 E 47th StreetBldg 2 Suite B
Chicago, IL 60653
Phone 773-891-2890 · Fax 773-891-4107
Authorized official
Reuben C Rutland
Chief Operation Officer
5742767184
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