Privy Health Inc

Primary specialty

Genetics Clinic/CenterTaxonomy code 261QG0250X

Legal business name

PRIVY HEALTH INC

Practice address

11 S Evergreen Ave
Arlington Heights, IL 60005-1427

Phone

(815) 861-1673

NPI assigned

Dec 21, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

John Distefano

Title

Clinic Director

Phone

(352) 317-3214

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1545350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1545350400000",
    "number": "1003388588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 S EVERGREEN AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S EVERGREEN AVE",
            "city": "ARLINGTON HEIGHTS",
            "state": "IL",
            "postal_code": "600051427",
            "telephone_number": "815-861-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIVY HEALTH INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-21",
        "last_updated": "2018-12-21",
        "status": "A",
        "authorized_official_last_name": "DISTEFANO",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "352-317-3214"
    },
    "taxonomies": [
        {
            "code": "261QG0250X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Genetics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Genetics Clinic/Center in Arlington Heights, IL
• Providers in Arlington Heights, IL by specialty
• Genetics Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.