Premier Wellcare, Inc.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Legal business name

PREMIER WELLCARE, INC.

Practice address

400 W. Higgins Rd.
Park Ridge, IL 60068

Phone

(312) 898-5064

NPI assigned

Apr 27, 2012

Organization subpart

No

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

Authorized official

Name

Samantha A. Vasich

Title

Wellness Program Manager

Phone

(312) 898-5064

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1335484800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337644800000",
    "number": "1639437684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 S LA SALLE ST",
            "address_2": "SUITE 2600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606033801",
            "telephone_number": "312-898-5064"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W. HIGGINS RD.",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "60068",
            "telephone_number": "312-898-5064"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER WELLCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-04-27",
        "last_updated": "2012-05-22",
        "status": "A",
        "authorized_official_last_name": "VASICH",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "WELLNESS PROGRAM MANAGER",
        "authorized_official_telephone_number": "312-898-5064"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nekaiya Jacobs Pratt, M.D.
• Preetha Ambika Prazad, M.D.
• Precision Performance and Sports Medicine
• Christine D Prekezes, MD
• Premier Rehab Services LLC
• Premier Wellness Care Inc.
• Premiere Anesthesia Group LLC
• Lauren K Prescott
• Presence Ambulatory Services
• Presence Ambulatory Services

• Physician Assistant in Park Ridge, IL
• Providers in Park Ridge, IL by specialty
• Physician Assistant in Illinois

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