| Edward Medical Group | |
|
1025 Ogden Ave Lisle IL 60532-4388 | |
| (630) 515-1667 | |
| (630) 515-1825 |
| Full Name | Edward Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1025 Ogden Ave, Lisle, Illinois |
| Authorized Official Name and Position | William G. Kottman (PRESIDENT) |
| Authorized Official Contact | 6306463950 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edward Medical Group 27555 Diehl Rd Warrenville IL 60555-3849 Ph: (630) 646-3950 | Edward Medical Group 1025 Ogden Ave Lisle IL 60532-4388 Ph: (630) 515-1667 |
| NPI Number | 1174573109 |
|---|---|
| Provider Enumeration Date | 05/11/2006 |
| Last Update Date | 03/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1174573109 | NPI | - | NPPES |
| 2222543 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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