Southdale Allergy and Asthma Clinic, LLC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

23905 Issued in MN

Legal business name

SOUTHDALE ALLERGY AND ASTHMA CLINIC, LLC

Practice address

4010 W 65TH St
#221
Minneapolis, MN 55435-1721

Phone

(952) 926-7630

Fax

(952) 926-2116

NPI assigned

Feb 27, 2007

Organization subpart

No

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

Authorized official

Name

Mrs. Pauline Schindeldecker

Title

Office Manager

Phone

(952) 926-7630

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1172534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1477680718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4010 W 65TH ST",
            "address_2": "#221",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554351721",
            "telephone_number": "952-926-7630",
            "fax_number": "952-926-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4010 W 65TH ST",
            "address_2": "#221",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554351721",
            "telephone_number": "952-926-7630",
            "fax_number": "952-926-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHDALE ALLERGY AND ASTHMA CLINIC, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-27",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHINDELDECKER",
        "authorized_official_first_name": "PAULINE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "952-926-7630",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Allergy & Immunology",
            "state": "MN",
            "license": "23905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Metro Human Services Dba Radias Health
• South Metro Human Services- Fact (RADIAS Health)
• South Minneapolis Meals on Wheels
• South Minneapolis Psychotherapy
• South Minneapolis Walk-in Clinic LLC
• Southdale Therapy Center LLC
• Southeast Asian Refugee Community Home
• Southgate Physical Therapy , LTD
• Southpointe Physical Therapy LLC
• Southside Care Center

• Allergy & Immunology Physician in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Allergy & Immunology Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.