Organization Active NPI

Premier Primary Care and Alternative Medicine

  • Internal Medicine Physician
  • Chicago, IL
National Provider Identifier
1003406000
Registry record updated Jun 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PREMIER PRIMARY CARE AND ALTERNATIVE MEDICINE
Practice address
1301 E 47TH Street
BLDG 2 Suite B
Chicago, IL 60653
Phone
(773) 891-2890
Fax
(773) 891-4107
NPI assigned
Jan 22, 2021
Organization subpart
Yes
Parent organization
PREMIER HEALTH NETWORK LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 28, 2021

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

Authorized official

Name
Reuben C Rutland I, MD, MBANPI 1497802151
Title
Chief Operation Officer
Phone
(574) 276-7184

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

1301 E 47TH Street
BLDG 2 Suite B
Chicago, IL 60653

Mailing address

1301 E 47TH Street
BLDG 2 Suite B
Chicago, IL 60653
Phone (773) 891-2890

National Provider Directory

National Provider Directory
Part of
Premier Health Network LLC

Locations

1301 E 47th St
Ste B
Chicago, IL 60653
Phone (773) 891-2890

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1624838400000",
    "number": "1003406000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 E 47TH STREET",
            "address_2": "BLDG 2 SUITE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60653",
            "telephone_number": "773-891-2890",
            "fax_number": "773-891-4107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E 47TH STREET",
            "address_2": "BLDG 2 SUITE B",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "60653",
            "telephone_number": "773-891-2890",
            "fax_number": "773-891-4107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER PRIMARY CARE AND ALTERNATIVE MEDICINE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER HEALTH NETWORK LLC",
        "enumeration_date": "2021-01-22",
        "last_updated": "2021-06-28",
        "certification_date": "2021-06-28",
        "status": "A",
        "authorized_official_last_name": "RUTLAND",
        "authorized_official_first_name": "REUBEN",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CHIEF OPERATION OFFICER",
        "authorized_official_telephone_number": "574-276-7184",
        "authorized_official_name_suffix": "I",
        "authorized_official_credential": "MD, MBA"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chicago, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2021; 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.