Provider Demographics
NPI:1467745430
Name:MD MEDICAL GROUP, S.C.
Entity Type:Organization
Organization Name:MD MEDICAL GROUP, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:L
Authorized Official - Last Name:DEES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-402-2962
Mailing Address - Street 1:PO BOX 5652
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-5652
Mailing Address - Country:US
Mailing Address - Phone:312-842-8505
Mailing Address - Fax:312-842-8521
Practice Address - Street 1:15 SPINNING WHEEL RD STE 210
Practice Address - Street 2:
Practice Address - City:HINSDALE
Practice Address - State:IL
Practice Address - Zip Code:60521-2984
Practice Address - Country:US
Practice Address - Phone:312-402-2962
Practice Address - Fax:312-842-8521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-24
Last Update Date:2011-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Multi-Specialty