Presence Medical Group

LBN: Presence Healthcare Services
Presence Medical Group is an health care organization with primary practice located at 112 S Northwest Hwy , Park Ridge IL 60068-4260. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as the primary health care specialty. Presence Healthcare Services can be contacted via phone (847) 696-3370, or through Wickliffe-Jones, Melvonne via phone (630) 914-2417.

Contact Information

Primary practice address
112 S Northwest Hwy Park Ridge IL 60068-4260
Fax: (847) 692-3884
Website:
Authorized official contact:
Name: Wickliffe-Jones, Melvonne

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X

Profile Details

NPI number 1518074608
LBN Legal business name Presence Healthcare Services
DBA Doing business as Presence Medical Group
Authorized official Wickliffe-Jones, Melvonne
Entity Organization
Organization subpart 1 No
Enumeration date Aug 24th, 2006
Last updated Apr 10th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1518074608 NPPES
Illinois MEDICAID 036121820
Illinois Other 036108128
Illinois MEDICAID 036119065
Illinois MEDICAID 036087005
Illinois MEDICAID 036080241
Illinois MEDICAID 036121594

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