Organization · NPI-2

31st Street Medical Center S.C.

Family Medicine · Tinley Park, IL

NPI number1750562187
StatusActive
Last updated in NPPESNov 14, 2007

Details

NPI
1750562187
Entity type
Organization (NPI-2)
Legal business name
31st Street Medical Center S.C.
Organization subpart
No
Enumeration date
Nov 14, 2007
Last updated
Nov 14, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207Q00000X Family Medicine––Yes

Practice location

16750 80th Ave
Suite B
Tinley Park, IL 60477-3173

Phone 708-429-7373 · Fax 708-429-7340

Mailing address

16750 80th Ave
Suite B
Tinley Park, IL 60477-3173

Phone 708-429-7373 · Fax 708-429-7340

Authorized official

Sheldon Allen Levine
President
7084297373

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