Axion Medical Group
General Practice in Chicago, IL. Organization (NPI-2).
NPI number1922671437
StatusActive
Last updated in NPPESJul 22, 2021
Details
- NPI
- 1922671437
- Entity type
- Organization (NPI-2)
- Legal business name
- Axion Medical Group
- Organization subpart
- No
- Enumeration date
- Jul 22, 2021
- Certification date
- Jul 21, 2021
- Last updated
- Jul 22, 2021
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 208D00000X | General Practice | – | – | Yes |
| 101YM0800X | Counselor, Mental Health | – | – | |
| 103TF0000X | Psychologist, Family | – | – | |
| 103TH0004X | Psychologist, Health | – | – | |
| 103TH0100X | Psychologist, Health Service | – | – | |
| 103TP0016X | Psychologist, Prescribing (Medical) | – | – | |
| 106H00000X | Marriage & Family Therapist | – | – | |
| 2083P0901X | Preventive Medicine, Public Health & General Preventive Medicine | – | – | |
| 261QP2300X | Clinic/Center, Primary Care | – | – | |
| 363AM0700X | Physician Assistant, Medical | – | – | |
| 363LA2200X | Nurse Practitioner, Adult Health | – | – | |
| 363LC1500X | Nurse Practitioner, Community Health | – | – | |
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | – | – | |
| 363LP2300X | Nurse Practitioner, Primary Care | – | – |
Practice location
7118 S Jeffery BlvdChicago, IL 60649-2426
Phone 702-460-5799
Mailing address
10627 Country Knoll WayLas Vegas, NV 89135-1258
Phone 702-243-2777
Authorized official
Allen Fobbs
President
7024605799
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