Provider Demographics
NPI:1356137384
Name:SPECTRUM HEALTH PARTNERS, LLC
Entity type:Organization
Organization Name:SPECTRUM HEALTH PARTNERS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:MOUSTOUKAS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-260-8169
Mailing Address - Street 1:898 ASH ST
Mailing Address - Street 2:
Mailing Address - City:WINNETKA
Mailing Address - State:IL
Mailing Address - Zip Code:60093-2436
Mailing Address - Country:US
Mailing Address - Phone:504-669-1233
Mailing Address - Fax:
Practice Address - Street 1:300 W BUTTERFIELD RD
Practice Address - Street 2:
Practice Address - City:ELMHURST
Practice Address - State:IL
Practice Address - Zip Code:60126-5017
Practice Address - Country:US
Practice Address - Phone:630-984-9880
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-16
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
No251E00000XAgenciesHome Health
No251G00000XAgenciesHospice Care, Community Based