Primary Physicians Diagnostics, LLC

Primary specialty

Non-Pharmacy Dispensing SiteTaxonomy code 332900000X

Legal business name

PRIMARY PHYSICIANS DIAGNOSTICS, LLC

Practice address

1806 Elmwood Dr
Highland Park, IL 60035-2303

Phone

(847) 831-5190

Fax

(847) 780-4503

NPI assigned

Jan 4, 2007

Organization subpart

No

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

Authorized official

Name

Stephen Hauer

Title

Owner

Phone

(847) 831-5190

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1167868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1740337476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1806 ELMWOOD DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352303",
            "telephone_number": "847-831-5190",
            "fax_number": "847-780-4503"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1806 ELMWOOD DR",
            "city": "HIGHLAND PARK",
            "state": "IL",
            "postal_code": "600352303",
            "telephone_number": "847-831-5190",
            "fax_number": "847-780-4503"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY PHYSICIANS DIAGNOSTICS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-04",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HAUER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "847-831-5190"
    },
    "taxonomies": [
        {
            "code": "332900000X",
            "taxonomy_group": "",
            "desc": "Non-Pharmacy Dispensing Site",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Non-Pharmacy Dispensing Site in Highland Park, IL
• Providers in Highland Park, IL by specialty
• Non-Pharmacy Dispensing Site in Illinois

• 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.