Healthcare Provider Details

I. General information

NPI: 1215394861
Provider Name (Legal Business Name): IPC HEALTHCARE SERVICES OF ILLINOIS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/26/2016
Last Update Date: 10/30/2020
Certification Date: 10/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1333 BUTTERFIELD RD SUITE 130
DOWNERS GROVE IL
60515-5607
US

IV. Provider business mailing address

1643 NW 136TH AVE STE 100
SUNRISE FL
33323-2857
US

V. Phone/Fax

Practice location:
  • Phone: 630-371-0133
  • Fax: 630-371-0138
Mailing address:
  • Phone: 800-424-3672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KENNETH PARSONS
Title or Position: PRESIDENT
Credential: M.D.
Phone: 865-693-1000