| Presence Medical Group | |
|
205 S Northwest Hwy Suite 130 Park Ridge IL 60068-5802 | |
| (847) 292-5200 | |
| Not Available |
| Full Name | Presence Medical Group |
|---|---|
| Speciality | Family Medicine |
| Location | 205 S Northwest Hwy, Park Ridge, Illinois |
| Authorized Official Name and Position | Daniel Mccormick (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 7085836817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Presence Medical Group 62311 Collection Center Dr Chicago IL 60693-0623 Ph: (800) 273-2614 | Presence Medical Group 205 S Northwest Hwy Suite 130 Park Ridge IL 60068-5802 Ph: (847) 292-5200 |
| NPI Number | 1235495631 |
|---|---|
| Provider Enumeration Date | 04/10/2012 |
| Last Update Date | 04/17/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235495631 | NPI | - | NPPES |
| 745367 | Other | IL | MEDICARE PTAN |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036080241 (Illinois) | Primary |
| 207R00000X | Internal Medicine | 036054785 (Illinois) | Secondary |
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