# GENERAL MEDICINE OF IL NURSE PRACTITIONERS, P.C.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1720253065
- **Authorized official:** THOMAS PROSE M.D. (PRESIDENT)
- **Authorized official phone:** (248) 662-0250

## Contact information

- **Practice address:** 21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
- **Practice address phone:** (248) 662-0250
- **Practice address fax:** (248) 662-9844
- **Mailing address:** 21333 HAGGERTY RD, SUITE 150, NOVI, MI 48375-5510
- **Mailing address phone:** (248) 662-0250
- **Mailing address fax:** (248) 662-9844

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363L00000X | Nurse Practitioner | — | IL | Yes |

## Other

- **Enumeration date:** 04/28/2008
- **Last updated:** 05/02/2008