Provider Demographics
NPI:1396464657
Name:MYCARE EXPRESS CARE INC
Entity type:Organization
Organization Name:MYCARE EXPRESS CARE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JIBRAN
Authorized Official - Middle Name:
Authorized Official - Last Name:NASEER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:309-319-2393
Mailing Address - Street 1:1404 EASTLAND DR STE 103
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IL
Mailing Address - Zip Code:61701-7904
Mailing Address - Country:US
Mailing Address - Phone:309-319-2393
Mailing Address - Fax:309-585-2607
Practice Address - Street 1:1404 EASTLAND DR STE 103
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IL
Practice Address - Zip Code:61701-7904
Practice Address - Country:US
Practice Address - Phone:309-319-2393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-22
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty