| Center For Internal Medicine And Preventive Care Pc | |
|
501 N Riverside Dr Suite 216 Gurnee IL 60031-5918 | |
| (847) 625-8300 | |
| (847) 625-8862 |
| Full Name | Center For Internal Medicine And Preventive Care Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 501 N Riverside Dr, Gurnee, Illinois |
| Authorized Official Name and Position | Paul Carter Tack (PRESIDENT) |
| Authorized Official Contact | 8476258300 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Center For Internal Medicine And Preventive Care Pc Po Box 436 Highland Park IL 60035-0436 Ph: (847) 625-8300 | Center For Internal Medicine And Preventive Care Pc 501 N Riverside Dr Suite 216 Gurnee IL 60031-5918 Ph: (847) 625-8300 |
| NPI Number | 1770770919 |
|---|---|
| Provider Enumeration Date | 10/02/2007 |
| Last Update Date | 07/17/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770770919 | NPI | - | NPPES |
| 110241112 | Other | IL | PALMETTO GBA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036097015 (Illinois) | Primary |
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