1053467027 NPI number — AMERICAN HEALTH CENTER, LTD.

Table of content: (NPI 1053467027)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1053467027 NPI number — AMERICAN HEALTH CENTER, LTD.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
AMERICAN HEALTH CENTER, LTD.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1053467027
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1640 N ARLINGTON HEIGHTS RD
Provider Second Line Business Mailing Address:
SUITE 210
Provider Business Mailing Address City Name:
ARLINGTON HEIGHTS
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60004-3985
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
847-255-7474
Provider Business Mailing Address Fax Number:
847-398-4585

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1640 N ARLINGTON HEIGHTS RD
Provider Second Line Business Practice Location Address:
SUITE 210
Provider Business Practice Location Address City Name:
ARLINGTON HEIGHTS
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60004-3985
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
847-255-7474
Provider Business Practice Location Address Fax Number:
847-398-4585
Provider Enumeration Date:
01/25/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
STERN
Authorized Official First Name:
TAMMY
Authorized Official Middle Name:
Authorized Official Title or Position:
V.P.
Authorized Official Telephone Number:
847-255-7400

Provider Taxonomy Codes

  • Taxonomy code: 207L00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207Q00000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207RG0100X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 207VG0400X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 2085U0001X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 208800000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 363LF0000X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 16-18658 . This is a "BLUE CROSS BLUE SHEILD #" identifier . This identifiers is of the category "OTHER".