MEDICARE: ASSOCIATED PHYSICIAN MEDICAL CENTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	336031070	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1235310053
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ASSOCIATED PHYSICIAN MEDICAL CENTER

Provider Business Mailing Address
First Line	:	1140 N MCLEAN BLVD
Second Line	:	SUITE E
City	:	ELGIN
State	:	IL
Zip	:	60123-1782
Country	:	US
Telephone Number	:	847-931-1400
Fax Number	:	847-931-2072

Provider Business Practice Location Address
First Line	:	1140 N MCLEAN BLVD
Second Line	:	SUITE E
City	:	ELGIN
State	:	IL
Zip	:	60123-1782
Country	:	US
Telephone Number	:	847-931-1400
Fax Number	:	847-931-2072

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ANGEL GOMEZ
Credential	:	M.D.
Telephone Number	:	847-931-1400

Provider Enumeration Date	:	11/20/2007
Last Update Date	:	10/31/2011

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