Provider Demographics
NPI:1952676405
Name:SENIOR CARE PHYSICIANS OF ILLINOIS, S.C.
Entity Type:Organization
Organization Name:SENIOR CARE PHYSICIANS OF ILLINOIS, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ELLIOT
Authorized Official - Middle Name:
Authorized Official - Last Name:KROGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:630-472-8800
Mailing Address - Street 1:1200 HARGER RD STE 408
Mailing Address - Street 2:
Mailing Address - City:OAK BROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60523-1818
Mailing Address - Country:US
Mailing Address - Phone:630-472-8800
Mailing Address - Fax:630-472-9502
Practice Address - Street 1:800 AUDUBON WAY
Practice Address - Street 2:
Practice Address - City:LINCOLNSHIRE
Practice Address - State:IL
Practice Address - Zip Code:60069-3811
Practice Address - Country:US
Practice Address - Phone:847-876-2200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-03-16
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty