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General NPI Number Information
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NPI Number | 1184569808
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Entity Type | Organization
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Legal Business Name | PRIMARY HEALTH AT HOME, PLLC
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Dates
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Enumeration Date | 04/20/2026
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Last Update Date | 04/20/2026
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Provider Practice Location Address
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Address Line | 328 VININGS DR
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2627
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Country | US
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Telephone | 616-416-5906
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Fax |
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Provider Business Mailing Address
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Address Line | 328 VININGS DR
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2627
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Country | US
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Telephone | 616-416-5906
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | MR. MARK ANTHONY ARTABA
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Credential | NP-C
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Telephone | 616-416-5906
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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