Primary Care Specialists, LLC

NPI #1154556843 in Bloomington, Illinois

Provider Information

NPI Number: 1154556843
Entity Type: Organization
Organization Name: Primary Care Specialists, LLC
Primary Specialty: Internal Medicine - Geriatric Medicine
Enumeration Date: May 25, 2009
Last Updated: Apr 15, 2010

Practice Location

Address: 2 AIRLINE DR
Address 2: SUITE 500
City: Bloomington
State: Illinois
ZIP Code: 61704-3433
Phone: (636) 579-6778

Authorized Official

Name: SRIVALLI VEGI, M.D.
Title: OWNER
Phone: (636) 579-6778

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Internal Medicine - Geriatric Medicine — Geriatric Medicine	207RG0300X	Primary

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