Primary Care West, S.C.

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

036088055 Issued in IL

Legal business name

PRIMARY CARE WEST, S.C.

Practice address

1300 N Highland Ave Ste 2
Aurora, IL 60506-1464

Phone

(630) 897-9600

Fax

(630) 897-9625

NPI assigned

Aug 30, 2007

Organization subpart

No

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

Authorized official

Name

Tina Bombard III

Title

Billing Director

Phone

(630) 897-6851

Specialties & licenses 2

Addresses

Other identifiers 2

Tax ID family

Primary Care West2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

• Primary Care West, S.C.

  • Health Service Clinic/Center
  • Aurora, IL
  • NPI 1154478766
  NPD tax ID

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dave Mante, M.D.

  • Internal Medicine Physician
  • Aurora, IL
  • NPI 1487701082
  NPD

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1297641600000",
    "number": "1750575940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 N HIGHLAND AVE STE 2",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061464",
            "telephone_number": "630-897-9600",
            "fax_number": "630-897-9625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1300 N HIGHLAND AVE STE 2",
            "city": "AURORA",
            "state": "IL",
            "postal_code": "605061464",
            "telephone_number": "630-897-9600",
            "fax_number": "630-897-9625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY CARE WEST, S.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-30",
        "last_updated": "2011-02-14",
        "status": "A",
        "authorized_official_last_name": "BOMBARD",
        "authorized_official_first_name": "TINA",
        "authorized_official_title_or_position": "BILLING DIRECTOR",
        "authorized_official_telephone_number": "630-897-6851",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Adult Medicine",
            "state": "IL",
            "license": "036088055",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "IL",
            "license": "036085384",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "001630376",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "201715",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kendall Price, DC
• Pearl Price
• Seretta Price
• Brittany Prigmore, LCSW
• Primary Care West, S.C.
• Phillip Prior, LPC
• Prism Pharmacy Aurora LLC
• Ashna Priyal
• Professional Medical Consultants
• Progressive Wellness and Rehabilitation SC

• Adult Medicine Physician in Aurora, IL
• Providers in Aurora, IL by specialty
• Adult Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; 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.