Healthcare Provider Details

I. General information

NPI: 1134801350
Provider Name (Legal Business Name): AFFIRMATIVE CARE SOLUTIONS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/07/2023
Last Update Date: 11/16/2023
Certification Date: 11/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

600 N LOGAN AVE
DANVILLE IL
61832-4375
US

IV. Provider business mailing address

600 N LOGAN AVE
DANVILLE IL
61832-4375
US

V. Phone/Fax

Practice location:
  • Phone: 317-213-8801
  • Fax:
Mailing address:
  • Phone: 217-213-6222
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207VC0300X
TaxonomyComplex Family Planning Physician
License Number
License Number State

VIII. Authorized Official

Name: LADONNA PRINCE
Title or Position: DIRECTOR
Credential:
Phone: 217-317-6222