Basic Information
| Provider Information | |||||||||
| NPI: | 1144831892 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | COMMUNITY PHYSICIANS PLLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1S450 SUMMIT AVE STE 165 | ||||||||
| Address2: | |||||||||
| City: | OAKBROOK TERRACE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 601813952 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Practice Location | |||||||||
| Address1: | 3160 LEWIS AVE | ||||||||
| Address2: | |||||||||
| City: | IDA | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481409703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6303206871 | ||||||||
| FaxNumber: | 6303850026 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2020 | ||||||||
| LastUpdateDate: | 08/14/2020 | ||||||||
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| AuthorizedOfficialLastName: | ALMOSHELLI | ||||||||
| AuthorizedOfficialFirstName: | BADER | ||||||||
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| AuthorizedOfficialTitleorPosition: | CHIEF MEDICAL OFFICER | ||||||||
| AuthorizedOfficialTelephone: | 6304081117 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 08/14/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208100000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation |
No ID Information.