Provider Demographics
NPI:1487854006
Name:C&R MEDICAL GROUP SC
Entity Type:Organization
Organization Name:C&R MEDICAL GROUP SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NAWROCKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-463-3700
Mailing Address - Street 1:PO BOX 66542
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60666-0542
Mailing Address - Country:US
Mailing Address - Phone:815-774-0548
Mailing Address - Fax:815-774-0573
Practice Address - Street 1:1890 SILVER CROSS BLVD STE 570
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-9606
Practice Address - Country:US
Practice Address - Phone:815-463-3700
Practice Address - Fax:815-463-3701
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-22
Last Update Date:2019-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036100791207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty