| Midwest Physician Group Ltd. | |
|
20110 Governors Hwy Suite 1 Olympia Fields IL 60461-1030 | |
| (708) 747-7960 | |
| (708) 503-3993 |
| Full Name | Midwest Physician Group Ltd. |
|---|---|
| Speciality | Family Medicine |
| Location | 20110 Governors Hwy, Olympia Fields, Illinois |
| Authorized Official Name and Position | Deborah J Nelson (CHIEF EXECUTIVE OFFICER) |
| Authorized Official Contact | 7087477960 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Physician Group Ltd. 20110 Governors Hwy Suite 1 Olympia Fields IL 60461-1030 Ph: (708) 747-7960 | Midwest Physician Group Ltd. 20110 Governors Hwy Suite 1 Olympia Fields IL 60461-1030 Ph: (708) 747-7960 |
| NPI Number | 1467405985 |
|---|---|
| Provider Enumeration Date | 05/18/2006 |
| Last Update Date | 12/10/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467405985 | NPI | - | NPPES |
| CA1946 | Other | IL | RAILROAD MEDICARE GROUP |
| CA7850 | Other | IL | RAILROAD MEDICARE GROUP |
| CD4066 | Other | IL | RAILROAD MEDICARE GROUP |
| C10237 | Other | IL | RAILROAD MEDICARE GROUP |
| 0001616617 | Other | IL | BLUE SHIELD ID |
| CC6202 | Other | IL | RAILROAD MEDICARE GROUP |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 42005377 (Illinois) | Primary |
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