Healthcare Provider Details

I. General information

NPI: 1245897024
Provider Name (Legal Business Name): FIRST STOP HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/28/2019
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

233 N MICHIGAN AVE STE 1400
CHICAGO IL
60601-5520
US

IV. Provider business mailing address

233 N MICHIGAN AVE STE 1400
CHICAGO IL
60601-5520
US

V. Phone/Fax

Practice location:
  • Phone: 888-691-7867
  • Fax: 888-691-7867
Mailing address:
  • Phone: 888-691-7867
  • Fax: 888-691-7867

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK FRIEDMAN
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 888-691-7867