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General NPI Number Information
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NPI Number | 1598550840
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Entity Type | Organization
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Legal Business Name | URGENT CARE CLINIC INC
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Dates
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Enumeration Date | 04/09/2025
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Last Update Date | 08/17/2025
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Provider Practice Location Address
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Address Line | 1815 AUTUMN DR APT 310
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-1180
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Country | US
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Telephone | 847-323-4491
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Fax |
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Provider Business Mailing Address
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Address Line | 1815 AUTUMN DR APT 310
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60169-1180
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Country | US
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Telephone | 847-323-4491
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Fax |
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Authorized Official
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Title or Position | OWNER/EMPLOYEE
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Name | MR. JOLLY P MACWAN
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Credential | NURSE PRACTITIONER
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Telephone | 847-881-7863
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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Taxonomy #2
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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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 | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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