Full Name | |
---|---|
Speciality | Family Medicine |
Location | 4282 E Rockton Rd, Roscoe, Illinois |
Authorized Official Name and Position | Don Daniels (VP) |
Authorized Official Contact | 8159662084 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Po Box 78866 Milwaukee WI 53278-8866 Ph: () - | 4282 E Rockton Rd Roscoe IL 61073 Ph: (779) 696-9000 |
NPI Number | 1386054062 |
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Provider Enumeration Date | 05/02/2014 |
Last Update Date | 07/12/2018 |
Identifier | Type | State | Issuer |
---|---|---|---|
1386054062 | NPI | - | NPPES |
082 | Other | IL | TRICARE SUFFIX # |
Life Balance Medical Center Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 5069 Edgemere Ct, Roscoe, IL 61073 Phone: 815-623-1013 Fax: 815-623-1017 | |