Prestige Medical Group LLC

Primary specialty

Health Service Clinic/CenterTaxonomy code 261QH0100X

Legal business name

PRESTIGE MEDICAL GROUP LLC

Practice address

8800 W 159TH St
Orland Park, IL 60462-5618

Phone

(708) 942-6843

NPI assigned

Apr 8, 2021

Organization subpart

No

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

Authorized official

Name

Anna Skobel

Title

Ceo

Phone

(708) 942-6843

Specialties & licenses 3

Addresses

Locations

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

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1618272000000",
    "number": "1801476502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 N VINE ST UNIT 614",
            "city": "NEW LENOX",
            "state": "IL",
            "postal_code": "604515032",
            "telephone_number": "708-942-6843"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8800 W 159TH ST",
            "city": "ORLAND PARK",
            "state": "IL",
            "postal_code": "604625618",
            "telephone_number": "708-942-6843"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRESTIGE MEDICAL GROUP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-13",
        "certification_date": "2021-04-13",
        "status": "A",
        "authorized_official_last_name": "SKOBEL",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-942-6843"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "291U00000X",
            "taxonomy_group": "",
            "desc": "Clinical Medical Laboratory",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Health Service Clinic/Center in Orland Park, IL
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• Health Service Clinic/Center in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; 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.