Provider Demographics
NPI:1649075060
Name:CONCIURGENT CARE PLLC
Entity type:Organization
Organization Name:CONCIURGENT CARE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JEREMY
Authorized Official - Middle Name:
Authorized Official - Last Name:SMILEY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-945-7891
Mailing Address - Street 1:840 S WAUKEGAN RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2619
Mailing Address - Country:US
Mailing Address - Phone:312-945-7891
Mailing Address - Fax:
Practice Address - Street 1:840 S WAUKEGAN RD STE 203
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2619
Practice Address - Country:US
Practice Address - Phone:312-945-7891
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-18
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care