PROVIDA FAMILY MEDICINE
NPI 1881890333
Family Medicine in Gurnee, IL
NPI Status: Active since June 22, 2007
Contact Information
1425 N HUNT CLUB RD STE 100
GURNEE, IL
ZIP 60031
Phone: (847) 548-2200
Fax: (847) 548-2865
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 14D0669448
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 09-26-2025
About PROVIDA FAMILY MEDICINE
This page provides the complete NPI Profile along with additional information for Provida Family Medicine, a primary care provider established in Gurnee, Illinois operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1881890333 assigned on June 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 042616958 (IL). The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a single speciality business group with one or more individual providers who practice the same area of specialization. The provider's is doing business as Provida Family Medicine. The authorized official of this NPI record is Luis I Salazar Md (Authorized Official)
- NPI
- 1881890333
- Provider Legal Name
- PROVIDA HEALTH CENTER SC
- Other Organization Name
- PROVIDA FAMILY MEDICINE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031
- Location Phone
- (847) 548-2200
- Location Fax
- (847) 548-2865
- Mailing Address
- 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031
- Mailing Phone
- (847) 548-2200
- Mailing Fax
- (847) 548-2865
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 06-22-2007
- Last Update Date
- 01-31-2024
- Code Navigator
A primary care provider (PCP) like Provida Family Medicine sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 042616958
- License State
- IL
- Taxonomy Description
- Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Group Taxonomy 193400000X SINGLE SPECIALTY GROUP
This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care + Rx Copay - PPO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - PPO
- Blue Choice Preferred Bronze PPO? 201 - PPO
- Blue Choice Preferred Bronze PPO? 701 - PPO
- Blue Choice Preferred Bronze PPO? Standard - Select Rx Copays - PPO
- Blue Choice Preferred Gold PPO? 204 - PPO
- Blue Choice Preferred Gold PPO? 901 - PPO
- Blue Choice Preferred Gold PPO? Standard - Rx Copays - PPO
- Blue Choice Preferred Security PPO? 200 - PPO
- Blue Choice Preferred Silver PPO? 203 - PPO
- Blue Choice Preferred Silver PPO? 801 - PPO
- Blue Choice Preferred Silver PPO? Standard - Select Rx Copays - PPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 14D0669448
- Facility Type
- Physician Office
- Certificate Effective Date
- September 27, 2023
- Certificate Expiration Date
- September 26, 2025
- Laboratory Director
- LUIS I. SALAZAR MD
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Provida Family Medicine to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 8 | 8 | 1 | 8 | 9 | 0 | 3 | 3 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 8 | 16 | 1 | 16 | 9 | 0 | 3 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 8 + 1 + 6 + 1 + 1 + 6 + 9 + 0 + 3 + 6 + 24 = 67 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 70 - 67 = 3 | 3 | ||||||||
The NPI number 1881890333 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 8 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1417942822 | DR. LUIS I SALAZAR M.D. Individual | Family Medicine | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1033773288 | MEGAN GREGORY KAHUE PA-C Individual | Physician Assistant (Medical) | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1245847656 | SUSIE ANNETTE GONZALEZ-LAZAREVIC APRN Individual | Nurse Practitioner (Family) | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1487343729 | MS. JESSIE L. DINELLI NP Individual | Nurse Practitioner (Family) | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1891568531 | ALEJANDRA CAMACHO FNP-C Individual | Nurse Practitioner (Family) | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1972663466 | MRS. ROSALVA ACOSTA PA-C Individual | Physician Assistant (Medical) | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1700442084 | DOMINIC ALESANDRINI PA-C Individual | Physician Assistant | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
| 1952733818 | KSENIA SAMVEL PA-C Individual | Physician Assistant | 1425 N HUNT CLUB RD STE 100 GURNEE, IL 60031 (847) 548-2200 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1881890333, enumerated in the NPI registry as an "organization" on June 22, 2007
The provider is located at 1425 N Hunt Club Rd Ste 100 Gurnee, Il 60031 and the phone number is (847) 548-2200
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Aetna CVS Health and Blue Cross and Blue Shield of. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 14D0669448 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on June 22, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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