| Oak Spring Medical Group Inc | |
|
131 E Park Ave Suite 103 Libertyville IL 60048-2800 | |
| (847) 968-2800 | |
| (847) 968-2801 |
| Full Name | Oak Spring Medical Group Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 131 E Park Ave, Libertyville, Illinois |
| Authorized Official Name and Position | Jennifer C Debruler (OWNER) |
| Authorized Official Contact | 8479682800 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Spring Medical Group Inc 131 E Park Ave Suite 103 Libertyville IL 60048-2800 Ph: (847) 968-2800 | Oak Spring Medical Group Inc 131 E Park Ave Suite 103 Libertyville IL 60048-2800 Ph: (847) 968-2800 |
| NPI Number | 1386660553 |
|---|---|
| Provider Enumeration Date | 07/14/2006 |
| Last Update Date | 10/09/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386660553 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036105592 (Illinois) | Primary |
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