| Life Medical Sc | |
|
1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 | |
| (847) 653-8413 | |
| (847) 292-0850 |
| Full Name | Life Medical Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1550 N Northwest Hwy, Park Ridge, Illinois |
| Authorized Official Name and Position | Joanna E Leszczak (PRACTICE MANAGER) |
| Authorized Official Contact | 8476538413 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Life Medical Sc 1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 Ph: (847) 653-8413 | Life Medical Sc 1550 N Northwest Hwy Suite 209 Park Ridge IL 60068-1411 Ph: (847) 653-8413 |
| NPI Number | 1245362847 |
|---|---|
| Provider Enumeration Date | 03/09/2007 |
| Last Update Date | 12/26/2012 |
| Medicare PECOS PAC ID | 7517914559 |
|---|---|
| Medicare Enrollment ID | O20050401000704 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245362847 | NPI | - | NPPES |
| 042.618530 | Other | IL | LICENCE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 042.618530 (Illinois) | Primary |
| Provider Name | Irma Kuptel |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1508808999 PECOS PAC ID: 5991752354 Enrollment ID: I20050408000485 |
| Provider Name | Jaroslaw R Leszczak |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1588606222 PECOS PAC ID: 9537116991 Enrollment ID: I20050411000709 |
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