| Sandwich Medical Clinic Sc | |
|
1310 North Main Str Ste 101 Sandwich IL 60548-1616 | |
| (815) 786-2173 | |
| (815) 786-2153 |
| Full Name | Sandwich Medical Clinic Sc |
|---|---|
| Speciality | Family Medicine |
| Location | 1310 North Main Str, Sandwich, Illinois |
| Authorized Official Name and Position | Martin Brauweiler (PRESIDENT) |
| Authorized Official Contact | 8157862173 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Sandwich Medical Clinic Sc 1310 North Main Street Suite 101 Sandwich IL 60548-1616 Ph: (815) 786-2173 | Sandwich Medical Clinic Sc 1310 North Main Str Ste 101 Sandwich IL 60548-1616 Ph: (815) 786-2173 |
| NPI Number | 1992921944 |
|---|---|
| Provider Enumeration Date | 04/18/2007 |
| Last Update Date | 01/11/2008 |
| Medicare PECOS PAC ID | 0648246298 |
|---|---|
| Medicare Enrollment ID | O20040907000218 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992921944 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Martin P Brauweiler |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1023059177 PECOS PAC ID: 0446226096 Enrollment ID: I20110125000228 |
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