National Provider Identifier Database

PRESENCE HEALTHCARE SERVICES
Allergy & Immunology

An internist doctor of osteopathy that specializes in the treatment of allergy and immunologic disorders. A doctor of osteopathy that is board eligible/certified by the American Osteopathic Board of Internal Medicine can obtain a Certificate of Special Qualifications in the field of Allergy & Immunology.


Contact Information

PRESENCE HEALTHCARE SERVICES
2800 N SHERIDAN RD
SUITE 309
CHICAGO, IL60657-6156
Phone: 773-871-4183
Fax: 773-883-1202
Website:
Specialty Taxonomy Code
* Allergy & Immunology 207RA0201X
Allergy & Immunology 207K00000X

* Indicates primary specialty

NPI Profile & details for PRESENCE HEALTHCARE SERVICES

NPI Number 1790078053
Legal business name
LBN
PRESENCE HEALTHCARE SERVICES
Authorized official MELVONNE WICKLIFFE-JONES - (CREDENTIALING MGR)
Entity Organization
Organization subpart No
Enumeration date 05/19/2011
Last updated 04/10/2013 - About 13 years ago
Sole proprietor1 Not specified
Identifiers
  • IL License #: 036043445
  • IL Medicaid: 036043445

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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