Main Street Medical Group Llc is a
General Practice based in O Fallon, Illinois. Main Street Medical Group Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is
124 Regency Park Ste 7, O Fallon, Illinois. It can be reached at their office (for appointments etc.) via phone at
(480) 926-2260.
NPI number for Main Street Medical Group Llc is 1043832769 and their current mailing address is 2250 E Germann Rd Ste 8, Chandler, Arizona. Main Street Medical Group Llc
does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1043832769.
Healthcare Provider's Profile
| Full Name | Main Street Medical Group Llc |
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| Type | Facility |
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| Speciality | General Practice |
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| Location | 124 Regency Park Ste 7, O Fallon, Illinois |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. The facility may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1043832769
- Provider Enumeration Date: 05/15/2020
- Last Update Date: 05/04/2021
Medical Identifiers
Medical identifiers for Main Street Medical Group Llc such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1043832769 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 111N00000X | Chiropractor | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| 225100000X | Physical Therapist | (* (Not Available)) | Secondary |
| 363A00000X | Physician Assistant | (* (Not Available)) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | (* (Not Available)) | Secondary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Main Street Medical Group Llc is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Main Street Medical Group Llc
2250 E Germann Rd Ste 8,
Chandler, AZ 85286-1575
Ph: (480) 926-7800 | Main Street Medical Group Llc
124 Regency Park Ste 7,
O Fallon, IL 62269-1994
Ph: (480) 926-2260 |
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