| Fox Prairie Medical Group P C | |
|
2560 Foxfield Rd Suite 160 St Charles IL 60174-5797 | |
| (630) 513-8734 | |
| Not Available |
| Full Name | Fox Prairie Medical Group P C |
|---|---|
| Speciality | Internal Medicine |
| Location | 2560 Foxfield Rd, St Charles, Illinois |
| Authorized Official Name and Position | Stasis Kahn (PARTNER) |
| Authorized Official Contact | 6305138734 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Fox Prairie Medical Group P C 2560 Foxfield Rd Suite 160 St Charles IL 60174-5797 Ph: (630) 513-8734 | Fox Prairie Medical Group P C 2560 Foxfield Rd Suite 160 St Charles IL 60174-5797 Ph: (630) 513-8734 |
| NPI Number | 1093836827 |
|---|---|
| Provider Enumeration Date | 04/02/2007 |
| Last Update Date | 11/09/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093836827 | NPI | - | NPPES |
| 036064522 | Medicaid | IL | |
| 036075143 | Medicaid | IL | |
| 036088803 | Medicaid | IL | |
| 04532093 | Other | IL | BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036075143 (Illinois) | Primary |
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