Provider Demographics
NPI:1033386586
Name:PREMIER MEDICAL CARE, LTD
Entity Type:Organization
Organization Name:PREMIER MEDICAL CARE, LTD
Other - Org Name:PREMIER OCCUPATIONAL HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANATOLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOROVITS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-972-0733
Mailing Address - Street 1:550 E BOUGHTON RD
Mailing Address - Street 2:# 140
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2100
Mailing Address - Country:US
Mailing Address - Phone:630-972-0733
Mailing Address - Fax:630-972-0749
Practice Address - Street 1:550 E BOUGHTON RD
Practice Address - Street 2:# 140
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2100
Practice Address - Country:US
Practice Address - Phone:630-972-0733
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-14
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036113828207R00000X
IL036113742207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL213313Medicare PIN
ILI48535Medicare UPIN
I50903Medicare UPIN
IL212911Medicare PIN