Organization · NPI-2

American Medical Group,ltd

Internal Medicine · Bourbonnais, IL

NPI number1417159385
StatusActive
Last updated in NPPESAug 22, 2020

Details

NPI
1417159385
Entity type
Organization (NPI-2)
Legal business name
American Medical Group,ltd
Organization subpart
No
Enumeration date
Jun 4, 2007
Last updated
Aug 22, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine036-091869ILYes

Practice location

1521 N Convent St
Bourbonnais, IL 60914-1468

Phone 708-715-7591

Mailing address

15542 Catalina Ct
Orland Park, IL 60462-5137

Authorized official

Vishnu Madireddy
Physician
7087157591

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