Provider Demographics
NPI:1326069329
Name:MEDICAL CARE SPECIALISTS LTD
Entity Type:Organization
Organization Name:MEDICAL CARE SPECIALISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:WOLF
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-677-8577
Mailing Address - Street 1:9700 KENTON AVE
Mailing Address - Street 2:SUITE K405
Mailing Address - City:SKOKIE
Mailing Address - State:IL
Mailing Address - Zip Code:60076-1259
Mailing Address - Country:US
Mailing Address - Phone:847-677-8577
Mailing Address - Fax:847-677-8574
Practice Address - Street 1:9700 KENTON AVE
Practice Address - Street 2:SUITE K405
Practice Address - City:SKOKIE
Practice Address - State:IL
Practice Address - Zip Code:60076-1259
Practice Address - Country:US
Practice Address - Phone:847-677-8577
Practice Address - Fax:847-677-8574
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL0001627455OtherBLUE CROSS/BLUE SHIELD
IL209431Medicare ID - Type Unspecified
ILF79093Medicare UPIN