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619 South 25th Avenue Bellwood IL 60104 | |
(708) 547-7951 | |
(708) 547-8192 |
Full Name | |
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Speciality | Family Medicine |
Location | 619 South 25th Avenue, Bellwood, Illinois |
Authorized Official Name and Position | Leonard Dedic (VICE PRESIDENT) |
Authorized Official Contact | 7085836818 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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619 South 25th Avenue Bellwood IL 60104 Ph: (708) 547-7951 | 619 South 25th Avenue Bellwood IL 60104 Ph: (708) 547-7951 |
NPI Number | 1851455588 |
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Provider Enumeration Date | 12/20/2006 |
Last Update Date | 10/26/2007 |
Identifier | Type | State | Issuer |
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1851455588 | NPI | - | NPPES |
214635 | Other | MEDICARE GROUP |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (Illinois) | Primary |
Advanced Occupational Medicine Specialists Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 2615 Harrison St, Bellwood, IL 60104 Phone: 708-493-0299 | |