Provider Demographics
NPI:1508505066
Name:PREMIER INJURY MANAGEMENT LTD
Entity Type:Organization
Organization Name:PREMIER INJURY MANAGEMENT LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ANATOLY
Authorized Official - Middle Name:
Authorized Official - Last Name:GOROVITS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:312-331-0589
Mailing Address - Street 1:550 E BOUGHTON RD STE 190
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-2188
Mailing Address - Country:US
Mailing Address - Phone:630-972-0733
Mailing Address - Fax:630-972-0749
Practice Address - Street 1:550 E BOUGHTON RD STE 190
Practice Address - Street 2:
Practice Address - City:BOLINGBROOK
Practice Address - State:IL
Practice Address - Zip Code:60440-2188
Practice Address - Country:US
Practice Address - Phone:630-972-0733
Practice Address - Fax:630-972-0749
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-06-02
Last Update Date:2022-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation