Summit Medical Center S.C.
Clinic/Center, Primary Care in Summit, IL. Organization (NPI-2).
NPI number1679744643
StatusActive
Last updated in NPPESAug 29, 2022
Details
- NPI
- 1679744643
- Entity type
- Organization (NPI-2)
- Legal business name
- Summit Medical Center S.C.
- Organization subpart
- No
- Enumeration date
- Mar 18, 2008
- Certification date
- Aug 29, 2022
- Last updated
- Aug 29, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QP2300X | Clinic/Center, Primary Care | 036086195 | IL | Yes |
Other names
- Summit Medical Center (Former Legal Business Name)
Practice location
6252 S Archer RdSummit, IL 60501-1720
Phone 708-496-9549 · Fax 708-728-9429
Mailing address
6252 S Archer RdSummit, IL 60501-1720
Phone 708-496-9549 · Fax 708-728-9429
Authorized official
Ankit Shah
President
7084969549
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