Provider Demographics
NPI:1104179365
Name:MIDWEST PROFESSIONAL MEDICAL CARE INC.
Entity Type:Organization
Organization Name:MIDWEST PROFESSIONAL MEDICAL CARE INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:
Authorized Official - Last Name:SANCHEZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-637-0050
Mailing Address - Street 1:5761 PROVIDENCE DR
Mailing Address - Street 2:
Mailing Address - City:HOFFMAN ESTATES
Mailing Address - State:IL
Mailing Address - Zip Code:60192-4590
Mailing Address - Country:US
Mailing Address - Phone:847-637-0050
Mailing Address - Fax:847-637-0050
Practice Address - Street 1:637 E GOLF RD
Practice Address - Street 2:SUITE 209
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-4967
Practice Address - Country:US
Practice Address - Phone:847-637-0050
Practice Address - Fax:847-637-0050
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-10-24
Last Update Date:2014-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036121934207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric MedicineGroup - Single Specialty