Organization
APP OF ILLINOIS ED PLLC
Active
Organization
APP OF ILLINOIS ED PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JAMES GRIMES (CFO)
(855) 246-8607
Entity
Organization
Contact information
Practice address
1324 N SHERIDAN RD, WAUKEGAN, IL 60085-2161
(847) 360-6930
(904) 559-4370
Mailing address
5121 MARYLAND WAY STE 300, BRENTWOOD, TN 37027-7516
(855) 246-8607
(629) 216-0568
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207Q00000X
Family Medicine Physician
—
—
363A00000X
Physician Assistant
—
—
363L00000X
Nurse Practitioner
—
—
Other
Enumeration date
10/03/2016
Last updated
01/26/2023
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