Provider Demographics
NPI:1982850855
Name:MIDWEST CENTER FOR DIGESTIVE HEALTH, SC
Entity Type:Organization
Organization Name:MIDWEST CENTER FOR DIGESTIVE HEALTH, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIEF FINANCIAL OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:
Authorized Official - Last Name:ARNDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-425-8616
Mailing Address - Street 1:9921 SOUTHWEST HWY
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-3767
Mailing Address - Country:US
Mailing Address - Phone:708-425-9456
Mailing Address - Fax:708-425-9468
Practice Address - Street 1:9921 SOUTHWEST HWY
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-3767
Practice Address - Country:US
Practice Address - Phone:708-425-9456
Practice Address - Fax:708-425-9468
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-08-12
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL1223OtherMEDICARE PTAN