Life Medical Sc | |
1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 | |
(847) 653-8413 | |
(847) 292-0850 |
Full Name | Life Medical Sc |
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Speciality | Internal Medicine |
Location | 1550 N Northwest Hwy, Park Ridge, Illinois |
Authorized Official Name and Position | Joanna E Leszczak (PRACTICE MANAGER) |
Authorized Official Contact | 8476538413 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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Life Medical Sc 1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 Ph: (847) 653-8413 | Life Medical Sc 1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 Ph: (847) 653-8413 |
NPI Number | 1245362847 |
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Provider Enumeration Date | 03/09/2007 |
Last Update Date | 12/26/2012 |
Medicare PECOS PAC ID | 7517914559 |
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Medicare Enrollment ID | O20050401000704 |
Identifier | Type | State | Issuer |
---|---|---|---|
1245362847 | NPI | - | NPPES |
042.618530 | Other | IL | LICENCE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 042.618530 (Illinois) | Primary |
Provider Name | Irma Kuptel |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1508808999 PECOS PAC ID: 5991752354 Enrollment ID: I20050408000485 |
Provider Name | Jaroslaw R Leszczak |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1588606222 PECOS PAC ID: 9537116991 Enrollment ID: I20050411000709 |
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