Provider Demographics
NPI:1740469618
Name:MEDICAL CONSULTANTS LTD
Entity type:Organization
Organization Name:MEDICAL CONSULTANTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LESLIE
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:LINDBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-432-4790
Mailing Address - Street 1:641 E GRANT ST
Mailing Address - Street 2:
Mailing Address - City:WATSEKA
Mailing Address - State:IL
Mailing Address - Zip Code:60970-1812
Mailing Address - Country:US
Mailing Address - Phone:815-432-4790
Mailing Address - Fax:815-432-5059
Practice Address - Street 1:641 E GRANT ST
Practice Address - Street 2:
Practice Address - City:WATSEKA
Practice Address - State:IL
Practice Address - Zip Code:60970-1812
Practice Address - Country:US
Practice Address - Phone:815-432-4790
Practice Address - Fax:815-432-5059
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-29
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL360367202085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILC38591Medicare UPIN
IL212260Medicare PIN