Asthma and Allergy Wellness Center LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

Legal business name

ASTHMA AND ALLERGY WELLNESS CENTER LLC

Practice address

2900 Foxfield Rd Ste 203
St Charles, IL 60174-5799

Phone

(630) 884-5704

NPI assigned

Dec 5, 2018

Organization subpart

No

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

Authorized official

Name

Priya Bansal, MDNPI 1811970486

Title

President

Phone

(630) 247-4304

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Locations

Practitioners 1

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

• Priya J Bansal, M.D.,

  • Allergy & Immunology Physician
  • Saint Charles, IL
  • NPI 1811970486
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1543968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1546992000000",
    "number": "1386115129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1187 CLEANDER CT",
            "city": "NAPERVILLE",
            "state": "IL",
            "postal_code": "605407352",
            "telephone_number": "630-247-4304"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 FOXFIELD RD STE 203",
            "city": "ST CHARLES",
            "state": "IL",
            "postal_code": "601745799",
            "telephone_number": "630-884-5704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ASTHMA AND ALLERGY WELLNESS CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-05",
        "last_updated": "2019-01-09",
        "status": "A",
        "authorized_official_last_name": "BANSAL",
        "authorized_official_first_name": "PRIYA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "630-247-4304",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207KA0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Allergy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207KI0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology, Clinical & Laboratory Immunology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Allergy & Immunology Physician in St Charles, IL
• Providers in St Charles, IL by specialty
• Allergy & Immunology Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2019; 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.