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NPI Code Detail

MEDICARE: EXCLUSIVE PHYSICIANS - ILLINOIS PLLC

MEDICARE: EXCLUSIVE PHYSICIANS - ILLINOIS PLLC
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
1207RA0000XAdolescent Medicine (Internal Medicine) Physician
2207RG0300XGeriatric Medicine (Internal Medicine) Physician
3261QM1300XMulti-Specialty Clinic/Center
4207Q00000XFamily Medicine Physician

General Provider Information

NPI Number : 1346055365
Entity Type Code : Organization
Provider Name (Legal Business Name) : EXCLUSIVE PHYSICIANS - ILLINOIS PLLC
Provider Business Mailing Address
First Line : 18000 W 9 MILE RD STE 200
Second Line :
City : SOUTHFIELD
State : MI
Zip : 48075-4020
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3000 N CICERO AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60641-5106
Country : US
Telephone Number : 248-336-4000
Fax Number :
Authorized Official
Title or Position : RCM
Name : NILLIAN SHAOUNI
Credential :
Telephone Number : 248-336-4000
Provider Enumeration Date : 02/07/2025
Last Update Date : 06/17/2025

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