Komprehensive Primary Care Sports & Musculoskeletal Medicine S.C.
Family Medicine, Sports Medicine in Posen, IL. Organization (NPI-2).
NPI number1285966440
StatusActive
Last updated in NPPESFeb 12, 2010
Details
- NPI
- 1285966440
- Entity type
- Organization (NPI-2)
- Legal business name
- Komprehensive Primary Care Sports & Musculoskeletal Medicine S.C.
- Organization subpart
- No
- Enumeration date
- Feb 12, 2010
- Last updated
- Feb 12, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207QS0010X | Family Medicine, Sports Medicine | 036114281 | IL | Yes |
Practice location
2813 W 147th StPosen, IL 60469-1516
Phone 708-396-9777 · Fax 708-396-9732
Mailing address
845 E 40th StChicago, IL 60653-2444
Phone 312-420-3445 · Fax 773-536-3263
Authorized official
Michael G Ward
President
3124203445
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