| Simple Primary Care LLC | |
|
2340 S Highland Ave Ste 270 Lombard IL 60148-5396 | |
| (630) 755-5881 | |
| Not Available |
| Full Name | Simple Primary Care LLC |
|---|---|
| Speciality | Nurse Practitioner |
| Location | 2340 S Highland Ave Ste 270, Lombard, Illinois |
| Authorized Official Name and Position | Uzma Shamsi (OWNER) |
| Authorized Official Contact | 6307760856 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Simple Primary Care LLC 2340 S Highland Ave Ste 270 Lombard IL 60148-5396 Ph: (630) 755-5881 | Simple Primary Care LLC 2340 S Highland Ave Ste 270 Lombard IL 60148-5396 Ph: (630) 755-5881 |
| NPI Number | 1609595966 |
|---|---|
| Provider Enumeration Date | 08/22/2022 |
| Last Update Date | 08/22/2022 |
| Certification Date | 08/22/2022 |
| Medicare PECOS PAC ID | 6002283934 |
|---|---|
| Medicare Enrollment ID | O20221107002646 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609595966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | () | Secondary |
| 363LF0000X | Nurse Practitioner - Family | () | Primary |
| Provider Name | Uzma T Shamsi |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1003334418 PECOS PAC ID: 1254690456 Enrollment ID: I20180116001631 |
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