Healthcare Provider Details

I. General information

NPI: 1164820098
Provider Name (Legal Business Name): ALEGIS CARE - MICHIGAN PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/09/2014
Last Update Date: 02/02/2022
Certification Date: 02/02/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

39555 ORCHARD HILL PL STE 13
NOVI MI
48375-5374
US

IV. Provider business mailing address

730 COOL SPRINGS BLVD STE 500
FRANKLIN TN
37067-7331
US

V. Phone/Fax

Practice location:
  • Phone: 773-292-4800
  • Fax: 312-564-4059
Mailing address:
  • Phone: 773-292-4800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: ROBYN C COLLINS
Title or Position: AUTHORIZED OFFICIAL
Credential:
Phone: 312-262-2739