Provider Demographics
NPI:1003177320
Name:MEDICAL ACCESS GROUP INC
Entity type:Organization
Organization Name:MEDICAL ACCESS GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:VELMA
Authorized Official - Middle Name:
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-356-4300
Mailing Address - Street 1:10001 W ROOSEVELT RD
Mailing Address - Street 2:SUITE 224
Mailing Address - City:WESTCHESTER
Mailing Address - State:IL
Mailing Address - Zip Code:60154-2664
Mailing Address - Country:US
Mailing Address - Phone:708-356-4300
Mailing Address - Fax:708-356-4301
Practice Address - Street 1:10001 W ROOSEVELT RD
Practice Address - Street 2:SUITE 224
Practice Address - City:WESTCHESTER
Practice Address - State:IL
Practice Address - Zip Code:60154-2664
Practice Address - Country:US
Practice Address - Phone:708-356-4300
Practice Address - Fax:708-356-4301
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-04
Last Update Date:2012-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service
No261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine