Healthcare Provider Details

I. General information

NPI: 1518583855
Provider Name (Legal Business Name): FIVE CLINICS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2020
Last Update Date: 05/18/2025
Certification Date: 05/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 ALKYRE RUN DR STE 350
WESTERVILLE OH
43082-6912
US

IV. Provider business mailing address

9400 S CICERO AVE STE 100
OAK LAWN IL
60453-2536
US

V. Phone/Fax

Practice location:
  • Phone: 614-362-2031
  • Fax: 888-732-7890
Mailing address:
  • Phone: 708-424-3201
  • Fax: 708-424-5001

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246XC2903X
TaxonomyVascular Specialist/Technologist Cardiovascular
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: THOMAS DOYLE
Title or Position: MEDICAL DIRECTOR
Credential: MD
Phone: 614-362-2031