Provider Demographics
NPI:1295522688
Name:AVID PRIMARY CARE LLC
Entity type:Organization
Organization Name:AVID PRIMARY CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:
Authorized Official - Last Name:FLICK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:618-977-3608
Mailing Address - Street 1:9965 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:ORLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60462-3113
Mailing Address - Country:US
Mailing Address - Phone:773-986-0976
Mailing Address - Fax:305-509-5868
Practice Address - Street 1:9965 W 151ST ST
Practice Address - Street 2:
Practice Address - City:ORLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60462-3113
Practice Address - Country:US
Practice Address - Phone:773-986-0976
Practice Address - Fax:305-509-5868
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-21
Last Update Date:2025-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric MedicineGroup - Single Specialty