Healthcare Provider Details

I. General information

NPI: 1912200825
Provider Name (Legal Business Name): MIDWEST ALLERGY INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2010
Last Update Date: 12/19/2025
Certification Date: 12/19/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 LARKIN AVE STE 203
ELGIN IL
60123-5878
US

IV. Provider business mailing address

10031 W ROOSEVELT RD STE 100
WESTCHESTER IL
60154-2669
US

V. Phone/Fax

Practice location:
  • Phone: 847-931-1999
  • Fax: 847-931-1721
Mailing address:
  • Phone: 847-931-1999
  • Fax: 847-931-1721

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number036-050567
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. VAL THOMAS-KATZ
Title or Position: BILLER
Credential:
Phone: 847-931-1999