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Contact Information

SPECIALTY PHYSICIANS OF ILLINOIS, LLC
1040 SIERRA DR STE 400
GREENWOOD, IN46143-7241
 Phone: 317-528-4291
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Internal Medicine

207R00000X 11 Physician/Internal Medicine
 

Allergy & Immunology

207K00000X 03 Physician/Allergy/ Immunology
 

Dermatology

207N00000X 07 Physician/Dermatology
 

Diagnostic Radiology

2085R0202X 30 Physician/Diagnostic Radiology
 

Diagnostic Ultrasound

2085U0001X
 

Family Medicine

207Q00000X 08 Physician/Family Practice
 

Neurology

2084N0400X 13 Physician/Neurology
 

Nuclear Medicine

207U00000X 36 Physician/Nuclear Medicine
 

Obstetrics & Gynecology

207V00000X 16 Physician/Obstetrics & Gynecology
 

Ophthalmology

207W00000X 18 Physician/Ophthalmology
 

Orthopaedic Surgery

207X00000X 02 Physician/General Surgery
 

Otolaryngology

207Y00000X 04 Physician/Otolaryngology
 

Pediatrics

208000000X 37 Physician/Pediatric Medicine
 

Surgery

208600000X 02 Physician/General Surgery
 

Urology

208800000X 34 Physician/Urology
Indicates primary specialty

NPI Profile & details for SPECIALTY PHYSICIANS OF ILLINOIS, LLC

NPI # 1124075676
LBN Legal business name SPECIALTY PHYSICIANS OF ILLINOIS, LLC
Authorized official DONNA PHALEN - (DIRECTOR)
Entity Organization
Organization subpart 1 No
Enumeration date 05/30/2006
Last updated 02/15/2023 - About 3 years ago
Identifiers
IL Other 203979 MEDICARE PTAN
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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