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NPI Code Detail

MEDICARE: ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C.

MEDICARE: ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C.
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
1207P00000XEmergency Medicine Physician

General Provider Information

NPI Number : 1710926647
Entity Type Code : Organization
Provider Name (Legal Business Name) : ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C.
Provider Business Mailing Address
First Line : PO BOX 7428
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19101-7428
Country : US
Telephone Number : 800-732-1066
Fax Number : 630-941-4333
Provider Business Practice Location Address
First Line : 12935 GREGORY ST
Second Line :
City : BLUE ISLAND
State : IL
Zip : 60406-2428
Country : US
Telephone Number : 708-597-2000
Fax Number : 708-824-4494
Authorized Official
Title or Position : OWNER, GENERAL PARTNER
Name : DR. DOUGLAS P WEBSTER
Credential : D.O.
Telephone Number : 800-732-1066
Provider Enumeration Date : 06/06/2006
Last Update Date : 03/24/2008

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Directions to “ILLINOIS/INDIANA EM-I MEDICAL SERVICES, S.C. ” Practice Location

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