Provider Demographics
NPI:1134801350
Name:AFFIRMATIVE CARE SOLUTIONS, LLC
Entity type:Organization
Organization Name:AFFIRMATIVE CARE SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:LADONNA
Authorized Official - Middle Name:
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:217-317-6222
Mailing Address - Street 1:600 N LOGAN AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:61832-4375
Mailing Address - Country:US
Mailing Address - Phone:217-213-6222
Mailing Address - Fax:
Practice Address - Street 1:600 N LOGAN AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:IL
Practice Address - Zip Code:61832-4375
Practice Address - Country:US
Practice Address - Phone:317-213-8801
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-07
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No207VC0300XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyComplex Family PlanningGroup - Multi-Specialty