Provider Demographics
NPI:1427038215
Name:PHYSICIANS PROMPT CARE CENTERS LLC
Entity type:Organization
Organization Name:PHYSICIANS PROMPT CARE CENTERS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:RICHARDSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-478-2500
Mailing Address - Street 1:18210 LA GRANGE RD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:TINLEY PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60487-7723
Mailing Address - Country:US
Mailing Address - Phone:708-478-2500
Mailing Address - Fax:708-478-2040
Practice Address - Street 1:18210 LA GRANGE RD
Practice Address - Street 2:SUITE 110
Practice Address - City:TINLEY PARK
Practice Address - State:IL
Practice Address - Zip Code:60487-7723
Practice Address - Country:US
Practice Address - Phone:708-478-2500
Practice Address - Fax:708-478-2040
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-19
Last Update Date:2011-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILDB2354OtherRAILROAD MEDICARE
ILDB2354OtherRAILROAD MEDICARE
IL207499Medicare ID - Type UnspecifiedGROUP NUMBER