| Primary Care Specialists, Llc | |
|
2 Airline Dr Suite 500 Bloomington IL 61704-3433 | |
| (636) 579-6778 | |
| Not Available |
| Full Name | Primary Care Specialists, Llc |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 2 Airline Dr, Bloomington, Illinois |
| Authorized Official Name and Position | Srivalli Vegi (OWNER) |
| Authorized Official Contact | 6365796778 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Primary Care Specialists, Llc 2 Airline Dr Suite 500 Bloomington IL 61704-3433 Ph: () - | Primary Care Specialists, Llc 2 Airline Dr Suite 500 Bloomington IL 61704-3433 Ph: (636) 579-6778 |
| NPI Number | 1154556843 |
|---|---|
| Provider Enumeration Date | 05/25/2009 |
| Last Update Date | 04/15/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154556843 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036121501 (Illinois) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | 036121501 (Illinois) | Primary |
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