| Midwest Family Physicians Ltd | |
|
9910 W 55th St Countryside IL 60525-3612 | |
| (708) 352-6166 | |
| Not Available |
| Full Name | Midwest Family Physicians Ltd |
|---|---|
| Speciality | Family Medicine |
| Location | 9910 W 55th St, Countryside, Illinois |
| Authorized Official Name and Position | Christopher Brenner (PRESIDENT) |
| Authorized Official Contact | 7083526166 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Midwest Family Physicians Ltd 9910 W 55th St Countryside IL 60525-3612 Ph: (708) 352-6166 | Midwest Family Physicians Ltd 9910 W 55th St Countryside IL 60525-3612 Ph: (708) 352-6166 |
| NPI Number | 1609993765 |
|---|---|
| Provider Enumeration Date | 03/23/2007 |
| Last Update Date | 10/14/2010 |
| Medicare PECOS PAC ID | 3274728126 |
|---|---|
| Medicare Enrollment ID | O20101117000707 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1609993765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Christopher P Brenner |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1629020102 PECOS PAC ID: 7810986874 Enrollment ID: I20040506001247 |
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