Presence Medical Group

LBN: Presence Healthcare Services
Presence Medical Group is an health care organization with primary practice located at 5600 W Addison St Suite 301, Chicago IL 60634-4401. The organization recently has only one registered license in Ambulatory Health Care Facilities / Primary Care, which is considered as the primary health care specialty. Presence Healthcare Services can be contacted via phone (773) 736-4553, or through Wickliffe-Jones, Melvonne via phone (630) 914-2417.

Contact Information

Primary practice address
5600 W Addison St Suite 301 Chicago IL 60634-4401
Phone: (773) 736-4553
Fax: (773) 205-1997
Website:
Map and Directions
Authorized official contact:
Name: Wickliffe-Jones, Melvonne
Phone: (630) 914-2417

Health care specialties

SpecialtyCodeLicense #State
Ambulatory Health Care Facilities / Primary Care 261QP2300X

Profile Details

NPI number 1093780181
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 Feb 22nd, 2006
Last updated Apr 10th, 2013 - about 13 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 1093780181 NPPES
Illinois MEDICAID 036067614

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