Provider Demographics
NPI:1548750227
Name:CORWIN HEALTH CARE, LLC
Entity Type:Organization
Organization Name:CORWIN HEALTH CARE, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRUCE
Authorized Official - Middle Name:C
Authorized Official - Last Name:CORWIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-666-8842
Mailing Address - Street 1:15728 S ROUTE 59 STE 108
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:IL
Mailing Address - Zip Code:60544-2693
Mailing Address - Country:US
Mailing Address - Phone:815-267-3700
Mailing Address - Fax:
Practice Address - Street 1:15728 S ROUTE 59 STE 108
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:IL
Practice Address - Zip Code:60544-2693
Practice Address - Country:US
Practice Address - Phone:815-267-3700
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-17
Last Update Date:2018-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty