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NPI Verification

National Provider Identifier: 1447870274

15 Park Place LLC

Organization

Primary Specialty

Internal Medicine

Code: 207R00000X

All Specialties (2)

Nurse Practitioner, Primary Care

Code: 363LP2300X

Internal Medicine

Code: 207R00000X

Primary

Practice Address

15 PARK PL STE 1

SWANSEA, IL 622262918

Phone: 618-580-1359

NPI Enumeration Date

April 22, 2020

NPI Number

1447870274

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry