Provider Demographics
NPI:1699806497
Name:UNIVERSAL HEALTHCLINICS, SC
Entity Type:Organization
Organization Name:UNIVERSAL HEALTHCLINICS, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:OBENG
Authorized Official - Last Name:APPIAGYEI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-278-7633
Mailing Address - Street 1:1585 BARRINGTON RD STE 505
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60169-5020
Mailing Address - Country:US
Mailing Address - Phone:847-278-7633
Mailing Address - Fax:847-885-4568
Practice Address - Street 1:1585 BARRINGTON RD STE 505
Practice Address - Street 2:
Practice Address - City:HOFFMAN ESTATES
Practice Address - State:IL
Practice Address - Zip Code:60169-5020
Practice Address - Country:US
Practice Address - Phone:847-278-7633
Practice Address - Fax:847-278-7633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2018-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036102176207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL036102176Medicaid
IL036102176Medicaid