Premier Optimal Health LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036076122 Issued in IL

Legal business name

PREMIER OPTIMAL HEALTH LLC

Practice address

150 N River Rd Ste 230
Des Plaines, IL 60016-1299

Phone

(847) 420-8345

NPI assigned

Jun 21, 2014

Organization subpart

No

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

Authorized official

Name

Doria Law Devare, M.D.NPI 1295731230

Title

Ceo

Phone

(847) 291-9108

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Practitioners 1

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

• Doria L Devare, M.D.

  • Family Medicine Physician
  • Des Plaines, IL
  • NPI 1295731230
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1403308800000",
    "number": "1245645928",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2492 FARNSWORTH LN",
            "city": "NORTHBROOK",
            "state": "IL",
            "postal_code": "600625945",
            "telephone_number": "847-291-9108"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 N RIVER RD STE 230",
            "city": "DES PLAINES",
            "state": "IL",
            "postal_code": "600161299",
            "telephone_number": "847-420-8345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER OPTIMAL HEALTH LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-21",
        "last_updated": "2014-06-21",
        "status": "A",
        "authorized_official_last_name": "DEVARE",
        "authorized_official_first_name": "DORIA",
        "authorized_official_middle_name": "LAW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "847-291-9108",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036076122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Premier Diagnostic Imaging Services Inc
• Premier Diagnostic Imaging Solutions, Inc.
• Premier Healthcare Partners, LLC
• Premier Healthcare Services LLC
• Premier Healthcare Services LLC
• Premier Radiology Institute I, LLC
• Brittany Prero, PT, DPT
• Presence Ambulatory Services
• Presence Ambulatory Services
• Presence Chicago Hospitals Network

• Family Medicine Physician in Des Plaines, IL
• Providers in Des Plaines, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.