| Park Forest Family Practice | |
|
344 Victory Dr Park Forest IL 60466-2003 | |
| (708) 481-0100 | |
| Not Available |
| Full Name | Park Forest Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 344 Victory Dr, Park Forest, Illinois |
| Authorized Official Name and Position | Matthew Todd Johnson (MANAGING PARTNER) |
| Authorized Official Contact | 7084810100 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Park Forest Family Practice 344 Victory Dr Park Forest IL 60466-2003 Ph: (708) 481-0100 | Park Forest Family Practice 344 Victory Dr Park Forest IL 60466-2003 Ph: (708) 481-0100 |
| NPI Number | 1144386202 |
|---|---|
| Provider Enumeration Date | 12/30/2006 |
| Last Update Date | 11/15/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144386202 | NPI | - | NPPES |
| 01634105 | Other | IL | BLUE CROSS ID# |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (Illinois) | Primary |
Aunt Martha's Youth Service Center, Inc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23485 Western Ave, Park Forest, IL 60466 Phone: 708-747-7100 | |
Grand Prairie Services Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 404 Sandburg St, Park Forest, IL 60466 Phone: 708-444-1012 |