# CENTEGRA PRIMARY CARE LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Other names:** CENTEGRA PHYSICIAN CARE MCHENRY COUNTY ORTHOPEDIC
- **Organization subpart:** No

## Provider details

- **NPI number:** 1356883599
- **Authorized official:** DAVID TOMLINSON (CIO & CFO)
- **Authorized official phone:** (815) 788-5831

## Contact information

- **Practice address:** 420 N IL ROUTE 31, CRYSTAL LAKE, IL 60012-3709
- **Practice address phone:** (815) 356-5200
- **Practice address fax:** (815) 356-5262
- **Mailing address:** 420 N IL ROUTE 31, CRYSTAL LAKE, IL 60012-3709
- **Mailing address phone:** (815) 356-5200
- **Mailing address fax:** (815) 356-5262

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/04/2016
- **Last updated:** 05/04/2017