| Mpfergus, Sc | |
|
13025 Conifer St Plainfield IL 60585-2989 | |
| (630) 253-8814 | |
| (815) 230-2608 |
| Full Name | Mpfergus, Sc |
|---|---|
| Speciality | Clinic/Center |
| Location | 13025 Conifer St, Plainfield, Illinois |
| Authorized Official Name and Position | Michael P Fergus (OWNER) |
| Authorized Official Contact | 6302538814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mpfergus, Sc Po Box 986 Plainfield IL 60544-0986 Ph: (630) 253-8814 | Mpfergus, Sc 13025 Conifer St Plainfield IL 60585-2989 Ph: (630) 253-8814 |
| NPI Number | 1467577874 |
|---|---|
| Provider Enumeration Date | 03/21/2007 |
| Last Update Date | 04/10/2008 |
| Medicare PECOS PAC ID | 8325098148 |
|---|---|
| Medicare Enrollment ID | O20050128000307 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467577874 | NPI | - | NPPES |
| 9932261 | Other | IL | BCBS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 042.618333 (Illinois) | Primary |
| Provider Name | Michael P Fergus |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1124027354 PECOS PAC ID: 7719962570 Enrollment ID: I20040624000222 |
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