MEDICARE: ALLIANCE PHYSICIANS GROUP LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207RC0000X	Cardiovascular Disease Physician
2	207RG0100X	Gastroenterology Physician
3	207RI0200X	Infectious Disease Physician
4	207RR0500X	Rheumatology Physician
5	207V00000X	Obstetrics & Gynecology Physician
6	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1518780006
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLIANCE PHYSICIANS GROUP LLC

Provider Business Mailing Address
First Line	:	1795 N BUTTERFIELD RD STE 203
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-1212
Country	:	US
Telephone Number	:	847-909-2088
Fax Number	:

Provider Business Practice Location Address
First Line	:	1795 N BUTTERFIELD RD STE 203
Second Line	:
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-1212
Country	:	US
Telephone Number	:	847-909-2088
Fax Number	:

Authorized Official
Title or Position	:	COO
Name	:	DALIA THOMAS
Credential	:
Telephone Number	:	847-909-2088

Provider Enumeration Date	:	11/04/2024
Last Update Date	:	11/04/2024

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