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General NPI Number Information
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NPI Number | 1629152574
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Entity Type | Organization
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Legal Business Name | FIVE APPLES INPATIENT SPECIALISTS
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 08/17/2021
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Provider Practice Location Address
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Address Line | 475 BROWN BLVD STE 103
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City | BOURBONNAIS
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State | IL
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Zip | 60914
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Country | US
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Telephone | 815-937-7962
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Fax | 815-936-8650
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Provider Business Mailing Address
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Address Line | 475 BROWN BLVD STE 103
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City | BOURBONNAIS
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State | IL
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Zip | 60914
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Country | US
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Telephone | 815-937-7962
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Fax | 815-936-8650
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Authorized Official
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Title or Position | OWNER
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Name | MR. TERRILL APPLEWHITE
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Credential | M.D.
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Telephone | 815-937-7962
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036104924
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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