Provider Demographics
NPI:1013235720
Name:MEDWORKS NEW LENOX CORP
Entity Type:Organization
Organization Name:MEDWORKS NEW LENOX CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:RENLIN
Authorized Official - Middle Name:
Authorized Official - Last Name:XIA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-744-0808
Mailing Address - Street 1:250 E MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:NEW LENOX
Mailing Address - State:IL
Mailing Address - Zip Code:60451-1871
Mailing Address - Country:US
Mailing Address - Phone:815-485-8544
Mailing Address - Fax:815-485-8531
Practice Address - Street 1:250 E MAPLE ST
Practice Address - Street 2:
Practice Address - City:NEW LENOX
Practice Address - State:IL
Practice Address - Zip Code:60451-1871
Practice Address - Country:US
Practice Address - Phone:815-485-8544
Practice Address - Fax:815-485-8531
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2015-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036-065509261QX0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QX0100XAmbulatory Health Care FacilitiesClinic/CenterOccupational Medicine