Prema Center, Inc.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

071-004368 Issued in IL

Legal business name

PREMA CENTER, INC.

Practice address

1800 Nations Dr
Suite 211-212
Gurnee, IL 60031-9168

Phone

(847) 548-0024

NPI assigned

Dec 1, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Chinni Chilamkurti, PH.D.

Title

Owner/Director

Phone

(847) 548-0024

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1417392000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1472428800000",
    "number": "1487051876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 NATIONS DR",
            "address_2": "SUITE 211-212",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319168",
            "telephone_number": "847-548-0024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1800 NATIONS DR",
            "address_2": "SUITE 211-212",
            "city": "GURNEE",
            "state": "IL",
            "postal_code": "600319168",
            "telephone_number": "847-548-0024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMA CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-01",
        "last_updated": "2016-08-29",
        "status": "A",
        "authorized_official_last_name": "CHILAMKURTI",
        "authorized_official_first_name": "CHINNI",
        "authorized_official_title_or_position": "OWNER/DIRECTOR",
        "authorized_official_telephone_number": "847-548-0024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PH.D."
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Clinical",
            "state": "IL",
            "license": "071-004368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Psychologist in Gurnee, IL
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• Clinical Psychologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2016; 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.