Organization
ALLINA HEALTH SYSTEM
Active
Other names
Allina Health Champlin Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
DOMINICA TALLARICO (COO)
(612) 222-2222
Entity
Organization
Contact information
Practice address
11269 JEFFERSON HWY N, CHAMPLIN, MN 55316-3123
(763) 236-0600
(763) 427-9626
Mailing address
PO BOX 43, MAIL ROUTE 10585, MINNEAPOLIS, MN 55440-0043
(612) 262-1166
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
Other
Enumeration date
01/27/2011
Last updated
02/26/2025
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