Provider Demographics
NPI:1023069994
Name:MIDWEST ACUTE CARE CONSULTANTS, PC
Entity type:Organization
Organization Name:MIDWEST ACUTE CARE CONSULTANTS, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NAT
Authorized Official - Middle Name:T
Authorized Official - Last Name:LEVY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-355-7500
Mailing Address - Street 1:PO BOX 66936
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63166-6936
Mailing Address - Country:US
Mailing Address - Phone:314-355-7500
Mailing Address - Fax:314-355-3287
Practice Address - Street 1:11155 DUNN RD
Practice Address - Street 2:STE: 315E
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6150
Practice Address - Country:US
Practice Address - Phone:314-355-7500
Practice Address - Fax:314-355-3287
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-15
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Multi-Specialty
No207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO505805101Medicaid
MOCJ4508Medicare ID - Type Unspecified
MO505805101Medicaid
IL996660Medicare ID - Type Unspecified
MO000013481Medicare ID - Type Unspecified