| Preston Family Practice | |
|
4479 Central Ave Western Springs IL 60558-1714 | |
| (708) 784-9000 | |
| (708) 784-9088 |
| Full Name | Preston Family Practice |
|---|---|
| Speciality | Clinic/center |
| Location | 4479 Central Ave, Western Springs, Illinois |
| Authorized Official Name and Position | Rebecca C Preston (OWNER) |
| Authorized Official Contact | 7087849000 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Preston Family Practice 4479 Central Ave Western Springs IL 60558-1714 Ph: (708) 784-9000 | Preston Family Practice 4479 Central Ave Western Springs IL 60558-1714 Ph: (708) 784-9000 |
| NPI Number | 1275726085 |
|---|---|
| Provider Enumeration Date | 08/24/2007 |
| Last Update Date | 03/19/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275726085 | NPI | - | NPPES |
| 50780 | Other | IL | TRICARE |
| 0021605429 | Other | IL | BLUE CROSS BLUE SHIELD |
| 036080973 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036080973 (Illinois) | Primary |
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