15 Park Place Llc
LBN: 15 Park Place Llc
15 Park Place Llc is an health care organization with primary practice located at 15 Park Pl Ste 1 , Swansea IL 62226-2918. The organization recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Physician Assistants & Advanced Practice Nursing Providers / Primary Care. Allopathic & Osteopathic Physicians / Internal Medicine is the primary health care specialty.
15 Park Place Llc can be contacted via phone (618) 580-1359, or through Ampadu, Clara via phone (618) 580-1359.
Contact Information
Primary practice address
15 Park Pl Ste 1
Swansea IL 62226-2918
Phone: (618) 580-1359
Fax: (618) 234-7242
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | ||
Physician Assistants & Advanced Practice Nursing Providers / Primary Care | 363LP2300X |
Profile Details
NPI number | 1447870274 |
---|---|
LBN Legal business name | 15 Park Place Llc |
DBA Doing business as | |
Authorized official | Ampadu, Clara FNPC |
Entity | Organization |
Organization subpart 1 | No |
Enumeration date | Apr 22nd, 2020 |
Last updated | Jul 8th, 2020 - about 4 years ago |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1447870274 | NPPES |
Illinois | MEDICAID | 0360832704 |
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