Family Medical Center Of Lagrange Ltd | |
5201 S Willow Springs Road Suite 300 Lagrange IL 60525 | |
(708) 482-8088 | |
(708) 482-9034 |
Full Name | Family Medical Center Of Lagrange Ltd |
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Speciality | Family Medicine |
Location | 5201 S Willow Springs Road, Lagrange, Illinois |
Authorized Official Name and Position | Michael Francis Dupont (VICE PRESIDENT PHYSICIAN) |
Authorized Official Contact | 7084828088 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Family Medical Center Of Lagrange Ltd 5201 S Willow Springs Road Suite 300 Lagrange IL 60525 Ph: (708) 482-8088 | Family Medical Center Of Lagrange Ltd 5201 S Willow Springs Road Suite 300 Lagrange IL 60525 Ph: (708) 482-8088 |
NPI Number | 1649355793 |
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Provider Enumeration Date | 10/26/2006 |
Last Update Date | 11/05/2012 |
Medicare PECOS PAC ID | 0749243939 |
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Medicare Enrollment ID | O20041109000404 |
Identifier | Type | State | Issuer |
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1649355793 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
Provider Name | Daniel Chen |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1356355812 PECOS PAC ID: 8921100751 Enrollment ID: I20070226000655 |
Provider Name | Scott D Robertson |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1376553875 PECOS PAC ID: 6901861772 Enrollment ID: I20101102001356 |
Provider Name | Michael Dupont |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1508817750 PECOS PAC ID: 5991760761 Enrollment ID: I20101103000257 |
Provider Name | Prachi I Patel |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1144545849 PECOS PAC ID: 2860615119 Enrollment ID: I20140514001084 |
Provider Name | Samuel J Traverso |
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Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1902464647 PECOS PAC ID: 4587091343 Enrollment ID: I20230210000201 |