Provider Demographics
NPI:1558502989
Name:MIDWEST EMERGENCY ASSOCIATES-FENTON, LLC
Entity Type:Organization
Organization Name:MIDWEST EMERGENCY ASSOCIATES-FENTON, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SAIF
Authorized Official - Middle Name:
Authorized Official - Last Name:NAZIR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-785-9100
Mailing Address - Street 1:1 TRANSAM PLAZA DR
Mailing Address - Street 2:STE 360
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181-4822
Mailing Address - Country:US
Mailing Address - Phone:630-785-9100
Mailing Address - Fax:630-785-9199
Practice Address - Street 1:1015 BOWLES AVE
Practice Address - Street 2:
Practice Address - City:FENTON
Practice Address - State:MO
Practice Address - Zip Code:63026-2394
Practice Address - Country:US
Practice Address - Phone:314-966-1500
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-16
Last Update Date:2011-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty