Provider Demographics
NPI:1649643131
Name:PHCS PLUS PROFESSIONAL CORPORATION
Entity type:Organization
Organization Name:PHCS PLUS PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THERESA
Authorized Official - Middle Name:M
Authorized Official - Last Name:MATZURA
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:630-529-7427
Mailing Address - Street 1:121 FAIRFIELD WAY
Mailing Address - Street 2:SUITE 207
Mailing Address - City:BLOOMINGDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60108
Mailing Address - Country:US
Mailing Address - Phone:630-529-7427
Mailing Address - Fax:630-529-9937
Practice Address - Street 1:121 FAIRFIELD WAY
Practice Address - Street 2:SUITE 207
Practice Address - City:BLOOMINGDALE
Practice Address - State:IL
Practice Address - Zip Code:60108
Practice Address - Country:US
Practice Address - Phone:630-529-7427
Practice Address - Fax:630-529-9937
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-11-05
Last Update Date:2015-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036757207207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty