PERFORMANCE MEDICAL CLINIC LLC – NPI #1255746715
Internal Medicine

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Health Care Provider Taxonomy Code for Internal Medicine

PERFORMANCE MEDICAL CLINIC LLC is a provider located in FAIRVIEW HEIGHTS, IL. NPPES has assigned the NPI number 1255746715 to PERFORMANCE MEDICAL CLINIC LLC on June 24, 2014. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “PERFORMANCE MEDICAL CLINIC LLC” is a dba name, the actual legal business name for this organization is CENTER FOR ADVANCED MEDICINE LLC. The primary taxonomy selected by this provider is 207R00000X from the Health Care Provider Taxonomy code set, which is classified as Internal Medicine.

The NPI profile was previously updated about 8 years ago on Jul 18, 2018. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for PERFORMANCE MEDICAL CLINIC LLC below.

NPI Profile for
CENTER FOR ADVANCED MEDICINE LLC

NPI Number
1255746715
Enumeration Date

(about 12 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTER FOR ADVANCED MEDICINE LLC
Doing Business As (dba): PERFORMANCE MEDICAL CLINIC LLC
Primary location
5036 N ILLINOIS ST
SUITE 1
FAIRVIEW HEIGHTS, IL 62208
Phone: (618) 671-6800 Fax: (619) 671-6604
Mailing address
Same as primary location
Organization Subpart
No
Authorized Official
MICHAEL AMBROSE
OWNER/CEO
Phone: (618) 420-9360
Updated
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

Taxonomy Classification / Specialization State License
207R00000X
- Internal Medicine (Primary)

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.