| Personalized Physicians Group Ltd | |
|
7 Blanchard Cir Ste. 106 Wheaton IL 60187-1037 | |
| (630) 580-7600 | |
| (630) 580-7624 |
| Full Name | Personalized Physicians Group Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 7 Blanchard Cir, Wheaton, Illinois |
| Authorized Official Name and Position | Scott Kolbaba (PRESIDENT) |
| Authorized Official Contact | 6305807600 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Personalized Physicians Group Ltd 7 Blanchard Cir Ste. 106 Wheaton IL 60187-1037 Ph: (630) 580-7600 | Personalized Physicians Group Ltd 7 Blanchard Cir Ste. 106 Wheaton IL 60187-1037 Ph: (630) 580-7600 |
| NPI Number | 1780706481 |
|---|---|
| Provider Enumeration Date | 04/04/2007 |
| Last Update Date | 08/24/2007 |
| Medicare PECOS PAC ID | 2062503493 |
|---|---|
| Medicare Enrollment ID | O20070814000352 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780706481 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Scott J Kolbaba |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1396776613 PECOS PAC ID: 5597856922 Enrollment ID: I20070814000376 |
| Provider Name | John R Born |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1225063357 PECOS PAC ID: 1951492388 Enrollment ID: I20070814000392 |
| Provider Name | Christine Bollier |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1710293576 PECOS PAC ID: 1153510722 Enrollment ID: I20110112001021 |
| Provider Name | Lindsey Victoria Fox |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1497360606 PECOS PAC ID: 5799105862 Enrollment ID: I20201012002789 |
| Provider Name | Lara Gorick |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902557184 PECOS PAC ID: 3779960166 Enrollment ID: I20220525000741 |
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