Provider Demographics
NPI:1417654708
Name:MIDWEST MEDICAL HEALTHCARE GROUP LTD
Entity Type:Organization
Organization Name:MIDWEST MEDICAL HEALTHCARE GROUP LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:MORGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:239-970-2484
Mailing Address - Street 1:2603 W 22ND ST STE 22
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-4637
Mailing Address - Country:US
Mailing Address - Phone:630-568-5942
Mailing Address - Fax:630-317-7504
Practice Address - Street 1:2603 W 22ND ST STE 22
Practice Address - Street 2:
Practice Address - City:OAK BROOK
Practice Address - State:IL
Practice Address - Zip Code:60523-4637
Practice Address - Country:US
Practice Address - Phone:630-568-5942
Practice Address - Fax:630-317-7504
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-08
Last Update Date:2023-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty