Provider Demographics
NPI:1083838569
Name:MIDWEST ACUTE CARE CONSULTANTS PC
Entity Type:Organization
Organization Name:MIDWEST ACUTE CARE CONSULTANTS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-7500
Mailing Address - Street 1:11155 DUNN RD STE 315E
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6111
Mailing Address - Country:US
Mailing Address - Phone:314-355-7500
Mailing Address - Fax:314-355-3287
Practice Address - Street 1:6812 STATE ROUTE 162 STE 202
Practice Address - Street 2:
Practice Address - City:MARYVILLE
Practice Address - State:IL
Practice Address - Zip Code:62062-8562
Practice Address - Country:US
Practice Address - Phone:618-288-6844
Practice Address - Fax:618-288-6847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-13
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036091456207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty