Provider Demographics
NPI:1629152574
Name:FIVE APPLES INPATIENT SPECIALISTS
Entity Type:Organization
Organization Name:FIVE APPLES INPATIENT SPECIALISTS
Other - Org Name:TERRILL APPLEWHITE,M.D.
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:TERRILL
Authorized Official - Middle Name:
Authorized Official - Last Name:APPLEWHITE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-937-7962
Mailing Address - Street 1:475 BROWN BLVD
Mailing Address - Street 2:STE 103
Mailing Address - City:BOURBONNAIS
Mailing Address - State:IL
Mailing Address - Zip Code:60914
Mailing Address - Country:US
Mailing Address - Phone:815-937-7962
Mailing Address - Fax:815-936-8650
Practice Address - Street 1:475 BROWN BLVD
Practice Address - Street 2:STE 103
Practice Address - City:BOURBONNAIS
Practice Address - State:IL
Practice Address - Zip Code:60914
Practice Address - Country:US
Practice Address - Phone:815-937-7962
Practice Address - Fax:815-936-8650
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-25
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036104924207R00000X
207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0136104924Medicaid