Provider Demographics
NPI:1235677196
Name:GUIDANCE HEALTHCARE, PLLC
Entity Type:Organization
Organization Name:GUIDANCE HEALTHCARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN /OWNER
Authorized Official - Prefix:
Authorized Official - First Name:THEODORE
Authorized Official - Middle Name:G
Authorized Official - Last Name:ENGELMANN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-947-2894
Mailing Address - Street 1:PO BOX 355
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MI
Mailing Address - Zip Code:48366-0355
Mailing Address - Country:US
Mailing Address - Phone:248-303-4680
Mailing Address - Fax:248-572-4995
Practice Address - Street 1:1990 UNION LAKE RD., STE 100
Practice Address - Street 2:
Practice Address - City:COMMERCE TWP
Practice Address - State:MI
Practice Address - Zip Code:48382-2200
Practice Address - Country:US
Practice Address - Phone:248-303-4680
Practice Address - Fax:248-572-4995
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-02-10
Last Update Date:2023-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101007018207Q00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty