Provider Demographics
NPI:1760836498
Name:CONCIERGE ALLERGY, LLC
Entity Type:Organization
Organization Name:CONCIERGE ALLERGY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:AARON
Authorized Official - Last Name:NAYAK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-888-1475
Mailing Address - Street 1:530 N LAKE SHORE DR
Mailing Address - Street 2:APT 807
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-7424
Mailing Address - Country:US
Mailing Address - Phone:312-888-1475
Mailing Address - Fax:
Practice Address - Street 1:530 N LAKE SHORE DR
Practice Address - Street 2:APT 807
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-7424
Practice Address - Country:US
Practice Address - Phone:312-888-1475
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-04-19
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty