1912074873 NPI number — ANOINTED HEALTH PARTNERS LIMITED

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 1912074873 NPI number — ANOINTED HEALTH PARTNERS LIMITED

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ANOINTED HEALTH PARTNERS LIMITED
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:
1912074873
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/01/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2315 EAST 93RD STREET
Provider Second Line Business Mailing Address:
SUITE 440
Provider Business Mailing Address City Name:
CHICAGO
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60617-3936
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
773-768-2535
Provider Business Mailing Address Fax Number:
773-374-4079

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2315 EAST 93RD STREET
Provider Second Line Business Practice Location Address:
SUITE 440
Provider Business Practice Location Address City Name:
CHICAGO
Provider Business Practice Location Address State Name:
IL
Provider Business Practice Location Address Postal Code:
60617-3936
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
773-768-2535
Provider Business Practice Location Address Fax Number:
773-374-4079
Provider Enumeration Date:
11/29/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SMITH
Authorized Official First Name:
GREGORY
Authorized Official Middle Name:
E
Authorized Official Title or Position:
MEDICAL DIRECTOR
Authorized Official Telephone Number:
773-768-2535

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1604779 , issued by the state of ( IL ) . This identifiers is of the category "MEDICAID".




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