| Thrive Healthcare Clinic Llc | |
|
524 W Stephenson St Ste 240 Freeport IL 61032-5057 | |
| (815) 541-6572 | |
| Not Available |
| Full Name | Thrive Healthcare Clinic Llc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 524 W Stephenson St Ste 240, Freeport, Illinois |
| Authorized Official Name and Position | Sarah Linder (PARTNER) |
| Authorized Official Contact | 8155506689 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Thrive Healthcare Clinic Llc 524 W Stephenson St Ste 240 Freeport IL 61032-5057 Ph: (815) 543-6216 | Thrive Healthcare Clinic Llc 524 W Stephenson St Ste 240 Freeport IL 61032-5057 Ph: (815) 541-6572 |
| NPI Number | 1154174761 |
|---|---|
| Provider Enumeration Date | 04/11/2024 |
| Last Update Date | 08/28/2024 |
| Certification Date | 08/28/2024 |
| Medicare PECOS PAC ID | 4981046190 |
|---|---|
| Medicare Enrollment ID | O20240520002182 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154174761 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084V0102X | Psychiatry & Neurology - Vascular Neurology | (* (Not Available)) | Primary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
| Provider Name | Vibhav Bansal |
|---|---|
| Provider Type | Practitioner - Neurology |
| Provider Identifiers | NPI Number: 1730337569 PECOS PAC ID: 2163680851 Enrollment ID: I20141110002095 |
| Provider Name | Sarah R Linder |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134603095 PECOS PAC ID: 8820332166 Enrollment ID: I20181127003409 |
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