Provider Demographics
NPI:1518601004
Name:MIDWEST REFUAH HEALTH CENTER
Entity Type:Organization
Organization Name:MIDWEST REFUAH HEALTH CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:BENJAMIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:FEINZIMER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:872-270-5999
Mailing Address - Street 1:6557 N LINCOLN AVE
Mailing Address - Street 2:
Mailing Address - City:LINCOLNWOOD
Mailing Address - State:IL
Mailing Address - Zip Code:60712-3934
Mailing Address - Country:US
Mailing Address - Phone:872-270-5999
Mailing Address - Fax:847-972-1789
Practice Address - Street 1:6374 N LINCOLN AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60659-1275
Practice Address - Country:US
Practice Address - Phone:872-270-5999
Practice Address - Fax:847-972-1789
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-04-21
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center