Provider Demographics
NPI:1083974380
Name:ACCESS IMMEDIATE CARE, LLC
Entity Type:Organization
Organization Name:ACCESS IMMEDIATE CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:FAZAL
Authorized Official - Middle Name:
Authorized Official - Last Name:MOHAMMAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-876-9000
Mailing Address - Street 1:1865 N NELTNOR BLVD
Mailing Address - Street 2:
Mailing Address - City:WEST CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60185-5900
Mailing Address - Country:US
Mailing Address - Phone:630-876-9000
Mailing Address - Fax:
Practice Address - Street 1:1865 N NELTNOR BLVD
Practice Address - Street 2:
Practice Address - City:WEST CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60185-5900
Practice Address - Country:US
Practice Address - Phone:630-876-9000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-21
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care