Provider Demographics
NPI:1043648785
Name:INTEGRATIVE MEDICAL GROUP, S.C.
Entity Type:Organization
Organization Name:INTEGRATIVE MEDICAL GROUP, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:M
Authorized Official - Last Name:SERPE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:630-548-9080
Mailing Address - Street 1:651 AMERSALE DR
Mailing Address - Street 2:SUITE 109
Mailing Address - City:NAPERVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60563-2587
Mailing Address - Country:US
Mailing Address - Phone:630-548-9080
Mailing Address - Fax:
Practice Address - Street 1:651 AMERSALE DR
Practice Address - Street 2:SUITE 109
Practice Address - City:NAPERVILLE
Practice Address - State:IL
Practice Address - Zip Code:60563-2587
Practice Address - Country:US
Practice Address - Phone:630-548-9080
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-15
Last Update Date:2013-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042-620192208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty