Provider Demographics
NPI:1780649277
Name:MIDWEST RHEUMATOLOGY CONSULTANTS, S. C.
Entity Type:Organization
Organization Name:MIDWEST RHEUMATOLOGY CONSULTANTS, S. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:J
Authorized Official - Last Name:IAMMARTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-268-0200
Mailing Address - Street 1:1 S. 224 SUMMIT
Mailing Address - Street 2:SUITE 107
Mailing Address - City:OAKBROOK TERRACE
Mailing Address - State:IL
Mailing Address - Zip Code:60181
Mailing Address - Country:US
Mailing Address - Phone:630-268-0200
Mailing Address - Fax:630-268-0233
Practice Address - Street 1:1 S. 224 SUMMIT
Practice Address - Street 2:SUITE 107
Practice Address - City:OAKBROOK TERRACE
Practice Address - State:IL
Practice Address - Zip Code:60181
Practice Address - Country:US
Practice Address - Phone:630-268-0200
Practice Address - Fax:630-268-0233
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL02223864OtherBCBS