| Premier Optimal Health Llc | |
|
150 N River Rd Ste 230 Des Plaines IL 60016-1299 | |
| (847) 420-8345 | |
| Not Available |
| Full Name | Premier Optimal Health Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 150 N River Rd Ste 230, Des Plaines, Illinois |
| Authorized Official Name and Position | Doria Law Devare (CEO) |
| Authorized Official Contact | 8472919108 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Premier Optimal Health Llc 2492 Farnsworth Ln Northbrook IL 60062-5945 Ph: (847) 291-9108 | Premier Optimal Health Llc 150 N River Rd Ste 230 Des Plaines IL 60016-1299 Ph: (847) 420-8345 |
| NPI Number | 1245645928 |
|---|---|
| Provider Enumeration Date | 06/21/2014 |
| Last Update Date | 06/21/2014 |
| Medicare PECOS PAC ID | 9830316314 |
|---|---|
| Medicare Enrollment ID | O20140806001667 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245645928 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036076122 (Illinois) | Primary |
| Provider Name | Doria L Devare |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1295731230 PECOS PAC ID: 4183768773 Enrollment ID: I20100220000041 |
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