Provider Demographics
NPI:1578658621
Name:PHYSICIAN CARE, LTD.
Entity Type:Organization
Organization Name:PHYSICIAN CARE, LTD.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEXANDER
Authorized Official - Middle Name:
Authorized Official - Last Name:NICHOLS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-253-3300
Mailing Address - Street 1:1925 E. RAND ROAD
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60004-4366
Mailing Address - Country:US
Mailing Address - Phone:847-253-3300
Mailing Address - Fax:847-253-3337
Practice Address - Street 1:1925 E. RAND ROAD
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60004-4366
Practice Address - Country:US
Practice Address - Phone:847-253-3300
Practice Address - Fax:847-253-3337
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL799800Medicare ID - Type UnspecifiedPROVIDER ID