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General NPI Number Information
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NPI Number | 1356137384
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Entity Type | Organization
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Legal Business Name | SPECTRUM HEALTH PARTNERS, LLC
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Dates
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Enumeration Date | 04/16/2025
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Last Update Date | 04/18/2025
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Provider Practice Location Address
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Address Line | 300 W BUTTERFIELD RD
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City | ELMHURST
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State | IL
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Zip | 60126-5017
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Country | US
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Telephone | 630-984-9880
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Fax |
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Provider Business Mailing Address
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Address Line | 898 ASH ST
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City | WINNETKA
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State | IL
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Zip | 60093-2436
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Country | US
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Telephone | 504-669-1233
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. JOHN NICHOLAS MOUSTOUKAS
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Credential | MD
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Telephone | 847-260-8169
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251E00000X
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Taxonomy Name | Home Health Agency
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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 | 251G00000X
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Taxonomy Name | Community Based Hospice Care Agency
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License Number |
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License Number State |
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Taxonomy #3
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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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