Provider Demographics
NPI:1063659654
Name:C & R MEDICAL GROUP, S.C.
Entity Type:Organization
Organization Name:C & R MEDICAL GROUP, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JITENDER
Authorized Official - Middle Name:R
Authorized Official - Last Name:SINGH
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-952-1412
Mailing Address - Street 1:PO BOX 66542
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60666-0542
Mailing Address - Country:US
Mailing Address - Phone:630-952-1412
Mailing Address - Fax:630-952-1447
Practice Address - Street 1:1301 COPPERFIELD AVE STE 210
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60432-2056
Practice Address - Country:US
Practice Address - Phone:815-774-0548
Practice Address - Fax:815-774-0573
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-19
Last Update Date:2009-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036089209207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty