| Waterford Medical Ltd | |
|
5958 W Lawrence Ave Chicago IL 60630-3130 | |
| (773) 282-4572 | |
| (630) 820-6730 |
| Full Name | Waterford Medical Ltd |
|---|---|
| Speciality | Internal Medicine |
| Location | 5958 W Lawrence Ave, Chicago, Illinois |
| Authorized Official Name and Position | Sanjoy Majumdar (PRESIDENT) |
| Authorized Official Contact | 6308206730 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Waterford Medical Ltd 5958 W Lawrence Ave Chicago IL 60630-3130 Ph: (773) 282-4572 | Waterford Medical Ltd 5958 W Lawrence Ave Chicago IL 60630-3130 Ph: (773) 282-4572 |
| NPI Number | 1194922245 |
|---|---|
| Provider Enumeration Date | 07/02/2007 |
| Last Update Date | 12/10/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194922245 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 036056086 (Illinois) | Primary |
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