Physician Urgent Care of Illinois, Inc.

Primary specialty

Urgent Care Clinic/CenterTaxonomy code 261QU0200X

Legal business name

PHYSICIAN URGENT CARE OF ILLINOIS, INC.

Practice address

1554 Todd Farm Dr
Elgin, IL 60123-1287

Phone

(847) 888-7423

Fax

(847) 841-7285

NPI assigned

Nov 6, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Naser Rustom, MD

Title

President

Phone

(773) 237-3500

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1352160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352160000000",
    "number": "1609120138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4941 N KEDZIE AVE",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606255009",
            "telephone_number": "773-309-6714",
            "fax_number": "773-309-6298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1554 TODD FARM DR",
            "city": "ELGIN",
            "state": "IL",
            "postal_code": "601231287",
            "telephone_number": "847-888-7423",
            "fax_number": "847-841-7285"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICIAN URGENT CARE OF ILLINOIS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-06",
        "last_updated": "2012-11-06",
        "status": "A",
        "authorized_official_last_name": "RUSTOM",
        "authorized_official_first_name": "NASER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "773-237-3500",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherry Pharr, CADC
• Deanna Phelan, DPT
• Deja Phillips, BSW
• Phoenix Family Center, LLC
• Phoenix Family Center, LLC
• Physicians Accountable Care Trust, LLC
• Jennifer Picciano, OT
• Katherine Piekarz, APN
• Daryl Pierce, MSW AND LSW
• Sara Elizabeth Piercey, LCPC

• Urgent Care Clinic/Center in Elgin, IL
• Providers in Elgin, IL by specialty
• Urgent Care Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2012; 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.