Allergy Clinic of Warren PC

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

MZ035093 Issued in MI

Legal business name

ALLERGY CLINIC OF WARREN PC

Practice address

28573 Schoenherr Rd
Warren, MI 48088-4330

Phone

(586) 558-5700

Fax

(586) 558-9402

NPI assigned

May 18, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Mark N Zacks, M D

Title

Owner

Phone

(586) 558-5700

Specialties & licenses 1

Addresses

Other identifiers 8

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joanna Hernandez, DNP, RN, AGACNP-BC

  • Gerontology Nurse Practitioner
  • Warren, MI
  • NPI 1548622251
  NPD (past)
• Alicia G Lumley, MD

  • Neurology Physician
  • Roseville, MI
  • NPI 1730283433
  NPD (past)
• Shyam Sunder Moudgil, MD

  • Neurology Physician
  • Roseville, MI
  • NPI 1740390848
  NPD (past)
• Yi Chul Sul, MD

  • Neurology Physician
  • Roseville, MI
  • NPI 1851492318
  NPD (past)
• Choon Soo Rim, MD

  • Neurology Physician
  • San Diego, CA
  • NPI 1083827273
  NPD (past)

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1365552000000",
    "number": "1750599569",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28573 SCHOENHERR RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884330",
            "telephone_number": "586-558-5700",
            "fax_number": "586-558-9402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "28573 SCHOENHERR RD",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480884330",
            "telephone_number": "586-558-5700",
            "fax_number": "586-558-9402"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ALLERGY CLINIC OF WARREN PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-18",
        "last_updated": "2013-04-10",
        "status": "A",
        "authorized_official_last_name": "ZACKS",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "586-558-5700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M D"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Allergy & Immunology",
            "state": "MI",
            "license": "MZ035093",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0501676",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICES",
            "identifier": "103944",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GREAT LAKES",
            "identifier": "103515",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PLUS",
            "identifier": "1162941",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1787391",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TOTAL HEALTH",
            "identifier": "84180",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "0501676",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAP",
            "identifier": "B45174",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Thirupathi Reddy Allala
• Allan H Morton Dopc
• Imraan Allarakhia, MD
• Brittney Allen-Hunter
• Jakyra Allen
• Alliance of Home Care Physicians, PC
• Paul Matthew Allison, PT
• Yazeed Khaled Almaet, MD
• Abdulmalik Alolofi, CAA
• Joanne Lynn Alonzo, D.O.

• All providers in Warren, MI
• Allergy & Immunology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2013; 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.