Provider Demographics
NPI:1295482933
Name:PRECISION EPILEPSY PLLC
Entity type:Organization
Organization Name:PRECISION EPILEPSY PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:MILLICHAP
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:833-530-3034
Mailing Address - Street 1:1 E ERIE ST STE 525-4066
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60611-2740
Mailing Address - Country:US
Mailing Address - Phone:833-530-3034
Mailing Address - Fax:833-464-3529
Practice Address - Street 1:1 E ERIE ST STE 525-4066
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60611-2740
Practice Address - Country:US
Practice Address - Phone:833-530-3034
Practice Address - Fax:833-464-3529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-02
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Single Specialty