Provider Demographics
NPI:1225561012
Name:HARPER HEALTH STREETERVILLE
Entity Type:Organization
Organization Name:HARPER HEALTH STREETERVILLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:R
Authorized Official - Last Name:HARPER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:855-947-7371
Mailing Address - Street 1:5119 S DORCHESTER AVE
Mailing Address - Street 2:SUITE 2020
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60615-4117
Mailing Address - Country:US
Mailing Address - Phone:855-947-7371
Mailing Address - Fax:312-284-4124
Practice Address - Street 1:737 N MICHIGAN AVE
Practice Address - Street 2:SUITE 2020
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2615
Practice Address - Country:US
Practice Address - Phone:855-947-7371
Practice Address - Fax:312-284-4124
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-07
Last Update Date:2017-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036097080261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care