1720117823 NPI number — ASSOCIATED ALLERGISTS AND ASTHMA SPECIALISTS, LTD

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1720117823 NPI number — ASSOCIATED ALLERGISTS AND ASTHMA SPECIALISTS, LTD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ASSOCIATED ALLERGISTS AND ASTHMA SPECIALISTS, 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:
1720117823
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10733 W. 165TH ST.
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ORLAND PARK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60467-8713
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
708-957-7468
Provider Business Mailing Address Fax Number:
708-957-7471

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
10733 W. 165TH ST.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ORLAND PARK
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60467-8713
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
708-957-7468
Provider Business Practice Location Address Fax Number:
708-957-7471
Provider Enumeration Date:
03/05/2007

Additional Information

Authorized Official

Authorized Official Last Name:
THOMPSON
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
ANDERSON
Authorized Official Title or Position:
SECRETARY
Authorized Official Telephone Number:
708-798-2950

Provider Taxonomy Codes

  • Taxonomy code: 207KA0200X , registered in the state of IL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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