1407871155 NPI number — MIDWEST EMERGENCY ASSOCIATES - LAKELAND, SC

Table of content: MS. COLLEEN MARIE HUGHES MSW, LCSW (NPI 1477630218)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1407871155 NPI number — MIDWEST EMERGENCY ASSOCIATES - LAKELAND, SC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MIDWEST EMERGENCY ASSOCIATES - LAKELAND, SC
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:
1407871155
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:
DEPT 4042 PO BOX 3834
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OAK BROOK
Provider Business Mailing Address State Name:
IL
Provider Business Mailing Address Postal Code:
60522-3834
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
630-875-1500
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
W3985 COUNTY ROAD NN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ELKHORN
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53121-4337
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
262-741-2000
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/13/2006

Additional Information

Authorized Official

Authorized Official Last Name:
SULLIVAN
Authorized Official First Name:
DANIEL
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
630-472-8800

Provider Taxonomy Codes

  • Taxonomy code: 207P00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





Copyright © 2007-2026 www.npivalidator.com