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General NPI Number Information
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NPI Number | 1205814118
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Entity Type | Organization
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Legal Business Name | PHYSICIANS IMMEDIATE CARE NORTH CHICAGO LLC
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 07/30/2025
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Provider Practice Location Address
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Address Line | 4211 N CICERO AVE SUITE 100
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City | CHICAGO
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State | IL
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Zip | 60641-1651
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Country | US
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Telephone | 815-713-2738
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Fax | 815-986-4217
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Provider Business Mailing Address
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Address Line | PO BOX 500
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City | ELLICOTTVILLE
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State | NY
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Zip | 14731-0500
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ROBERT BIERNBAUM
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Credential | DO
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Telephone | 585-430-8600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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