Organization
SPECIALTY PHYSICIANS OF ILLINOIS, LLC
Active
Other names
Wellgroup Healthpartners LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA PHALEN (DIRECTOR)
(219) 554-4548
Entity
Organization
Contact information
Practice address
20180 S LAGRANGE RD, FRANKFORT, IL 60423-3153
(815) 464-2010
Mailing address
35318 EAGLE WAY, CHICAGO, IL 60678-1353
(317) 528-4800
(317) 865-1479
Taxonomy
Speciality
Code
Description
License number
State
261QU0200X
Urgent Care Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
203979
GROUP MEDICARE NUMBER
IL
01
—
7002769
LICENSE ID NUMBER
IL
Enumeration date
05/15/2020
Last updated
02/27/2023
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