MEDICARE: PRECISE HEALTHCARE SOLUTIONS LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	291U00000X	Clinical Medical Laboratory
2	261QH0100X	Health Service Clinic/Center

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1356744452	OTHER	IL	NPI

General Provider Information

NPI Number	:	1336800630
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	PRECISE HEALTHCARE SOLUTIONS LLC

Provider Business Mailing Address
First Line	:	3200 BROOKSIDE BLVD
Second Line	:
City	:	OLYMPIA FIELDS
State	:	IL
Zip	:	60461-1863
Country	:	US
Telephone Number	:	708-833-9014
Fax Number	:

Provider Business Practice Location Address
First Line	:	3235 VOLLMER RD STE 104
Second Line	:
City	:	FLOSSMOOR
State	:	IL
Zip	:	60422-2069
Country	:	US
Telephone Number	:	708-631-3917
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	KRISTI HUGHES
Credential	:	DNP, FNP-BC
Telephone Number	:	708-833-9014

Provider Enumeration Date	:	01/07/2022
Last Update Date	:	01/18/2022

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