Provider Demographics
NPI:1245314616
Name:FORWARD FOCUS MEDICAL CARE LLC
Entity type:Organization
Organization Name:FORWARD FOCUS MEDICAL CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:MARY
Authorized Official - Last Name:MICHEL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-234-8100
Mailing Address - Street 1:990 S WAUKEGAN RD STE 200
Mailing Address - Street 2:
Mailing Address - City:LAKE FOREST
Mailing Address - State:IL
Mailing Address - Zip Code:60045-2654
Mailing Address - Country:US
Mailing Address - Phone:847-234-8100
Mailing Address - Fax:847-234-8199
Practice Address - Street 1:990 S WAUKEGAN RD STE 200
Practice Address - Street 2:
Practice Address - City:LAKE FOREST
Practice Address - State:IL
Practice Address - Zip Code:60045-2654
Practice Address - Country:US
Practice Address - Phone:847-234-8100
Practice Address - Fax:847-234-8199
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-24
Last Update Date:2024-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty