Healthcare Provider Details
I. General information
NPI: 1538083316
Provider Name (Legal Business Name): PREMIER OAK PARK HEALTH PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 08/05/2026
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
15300 W 9 MILE RD STE 1
OAK PARK MI
48237-2585
US
IV. Provider business mailing address
15300 W 9 MILE RD STE 1
OAK PARK MI
48237-2585
US
V. Phone/Fax
- Phone: 470-592-1168
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
NORA
LINARES
Title or Position: OWNER
Credential: DO
Phone: 470-592-1168