Provider Demographics
NPI:1679898415
Name:MIDWEST ASSOCIATES IN PRIMARY CARE LTD
Entity Type:Organization
Organization Name:MIDWEST ASSOCIATES IN PRIMARY CARE LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:CARMELITA
Authorized Official - Middle Name:ROWENA
Authorized Official - Last Name:ROBINSON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:773-221-1400
Mailing Address - Street 1:PO BOX 805192
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60680-4113
Mailing Address - Country:US
Mailing Address - Phone:773-221-1400
Mailing Address - Fax:773-221-3258
Practice Address - Street 1:8741 S GREENWOOD AVE STE 104
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60619-7058
Practice Address - Country:US
Practice Address - Phone:773-221-1400
Practice Address - Fax:773-221-3258
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-05
Last Update Date:2010-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL042007900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty