| Oak Brook Medical Group Ltd | |
|
2603 W 22nd St Ste 22 Oak Brook IL 60523-4637 | |
| (630) 317-7478 | |
| (630) 317-7504 |
| Full Name | Oak Brook Medical Group Ltd |
|---|---|
| Speciality | General Practice |
| Location | 2603 W 22nd St Ste 22, Oak Brook, Illinois |
| Authorized Official Name and Position | Barry Wolf (BILLING MANAGER) |
| Authorized Official Contact | 2399702484 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Oak Brook Medical Group Ltd 2603 W 22nd St Ste 22 Oak Brook IL 60523-4637 Ph: (630) 317-7478 | Oak Brook Medical Group Ltd 2603 W 22nd St Ste 22 Oak Brook IL 60523-4637 Ph: (630) 317-7478 |
| NPI Number | 1366941510 |
|---|---|
| Provider Enumeration Date | 02/02/2018 |
| Last Update Date | 11/30/2020 |
| Medicare PECOS PAC ID | 6901157239 |
|---|---|
| Medicare Enrollment ID | O20180925002739 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1366941510 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
| Provider Name | James E Wilson |
|---|---|
| Provider Type | Practitioner - Interventional Pain Management |
| Provider Identifiers | NPI Number: 1265490239 PECOS PAC ID: 6305747718 Enrollment ID: I20040320000617 |
| Provider Name | Martha E Quigley |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1134677065 PECOS PAC ID: 9931488277 Enrollment ID: I20161109001894 |
| Provider Name | Michael W Hall |
|---|---|
| Provider Type | Practitioner - Chiropractic |
| Provider Identifiers | NPI Number: 1144614587 PECOS PAC ID: 1557690138 Enrollment ID: I20190906001298 |
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