| D.o.c. Family Practice | |
|
6723 Roosevelt Rd Berwyn IL 60402-1007 | |
| (708) 383-6346 | |
| (708) 383-6346 |
| Full Name | D.o.c. Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 6723 Roosevelt Rd, Berwyn, Illinois |
| Authorized Official Name and Position | Ruby Mann (DIRECTOR) |
| Authorized Official Contact | 6308566884 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| D.o.c. Family Practice 6723 Roosevelt Rd Berwyn IL 60402-1007 Ph: (708) 383-6346 | D.o.c. Family Practice 6723 Roosevelt Rd Berwyn IL 60402-1007 Ph: (708) 383-6346 |
| NPI Number | 1659624849 |
|---|---|
| Provider Enumeration Date | 10/25/2012 |
| Last Update Date | 06/12/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1659624849 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
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