Evergreen Aesthetic Institute Llc in Effingham - Ambulatory Fertility Facility
Evergreen Aesthetic Institute Llc - NPI 1710073176
Evergreen Aesthetic Institute Llc is a Ambulatory Fertility Facility in Effingham, Illinois. Evergreen Aesthetic Institute Llc practices all healthcare services and medical treatments related to Ambulatory Fertility Facility. The NPI Number for Evergreen Aesthetic Institute Llc is 1710073176. The last update date is 2020-08-22.
Evergreen Aesthetic Institute Llc's current location address is 1104 W Evergreen Ave, Effingham, Illinois. You can contact this provider via phone number 2173427090 and fax number 2173427094. The mailing address for Evergreen Aesthetic Institute Llc is 1104 W Evergreen Ave, Effingham, Illinois. To know further, please read the information below!
Provider Profile Detail
| Provider Organization | Evergreen Aesthetic Institute Llc |
|---|---|
| Address | 1104 W Evergreen Ave, Effingham, Illinois |
| Phone Number | 2173427090 |
| Fax Number | 2173427094 |
| Sole Proprietor | -- |
| Credentials | -- |
Authorized Official
| Title or Position | MEDICAL DI |
|---|---|
| Authorized Official Name | Fifer Theodore |
| Credentials | MD |
| Telephone Number | 2173427090 |
NPI Number Detail
| NPI Number | 1710073176 |
|---|---|
| Provider Enumeration Date | 2006-10-05 |
| Last Updated Date | 2020-08-22 |
Provider Mailing Address Detail
| Address | 1104 W Evergreen Ave |
|---|---|
| City | Effingham |
| State | Illinois (IL) |
| Post Code | 624011710 |
| Phone Number | 2173427090 |
| Fax Number | 2173427094 |
Provider's Primary Taxonomy Detail
| Speciality | Ambulatory Fertility Facility |
|---|---|
| Taxonomy | 261Qa0006X |
| Licence No | 2198 |
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Definition: A fertility facility, which may be licensed, registered, or certified in some states, that is not hospital-based, where services are provided at a fixed specific location. An Ambulatory Fertility Facility does not provide overnight accommodations. Th |
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What is the Evergreen Aesthetic Institute Llc's 1710073176?
The Evergreen Aesthetic Institute Llc's NPI (National Provider Identifier) Number is 1710073176. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Evergreen Aesthetic Institute Llc's facilities are geographically located?
The facilities of Evergreen Aesthetic Institute Llc are physically situated at the following location: 1104 W Evergreen Ave, Effingham, IL, 624011710.
What is Evergreen Aesthetic Institute Llc's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Evergreen Aesthetic Institute Llc is Ambulatory Fertility Facility, and the corresponding taxonomy classification code for this specialized field is 261Qa0006X.
When did Evergreen Aesthetic Institute Llc receive its 1710073176 assignment?
The Evergreen Aesthetic Institute Llc was assigned its 1710073176 on 2006-10-05, which is the date when this unique identifier was issued to the organization.
As of what date were the details pertaining to Evergreen Aesthetic Institute Llc last refreshed?
The information related to the Evergreen Aesthetic Institute Llc, including its address, specialty, and other relevant details, was last updated on 2020-08-22.
NPI Number: 1720081763
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