Healthcare Provider Details

I. General information

NPI: 1003043233
Provider Name (Legal Business Name): AFFINITY HEALTHCARE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2009
Last Update Date: 06/15/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1450 BUSCH PARKWAY
BUFFALO GROVE IL
60089
US

IV. Provider business mailing address

1450 BUSCH PARKWAY
BUFFALO GROVE IL
60089
US

V. Phone/Fax

Practice location:
  • Phone: 847-459-7860
  • Fax: 847-459-4228
Mailing address:
  • Phone: 847-459-7860
  • Fax: 847-459-4228

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MRS. LINDA AEMISEGGER
Title or Position: COORDINATOR
Credential:
Phone: 847-487-0973