Healthcare Provider Details

I. General information

NPI: 1891199154
Provider Name (Legal Business Name): APEX NORTHWEST HEALTHCARE S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/15/2014
Last Update Date: 03/14/2023
Certification Date: 03/14/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 W HIGGINS RD STE 1120
HOFFMAN ESTATES IL
60169-2050
US

IV. Provider business mailing address

2500 W HIGGINS RD STE 1120
HOFFMAN ESTATES IL
60169-2050
US

V. Phone/Fax

Practice location:
  • Phone: 847-906-3022
  • Fax: 855-754-0596
Mailing address:
  • Phone: 847-906-3022
  • Fax: 855-754-0596

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number036117480
License Number StateIL

VIII. Authorized Official

Name: POONAM GILL
Title or Position: OWNER/CEO
Credential: MD
Phone: 847-906-3022