Healthcare Provider Details

I. General information

NPI: 1770989584
Provider Name (Legal Business Name): ALEXIAN BROTHERS MEDICAL CARE GROUP NFP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

IV. Provider business mailing address

3040 W SALT CREEK LN
ARLINGTON HEIGHTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 847-870-4780
  • Fax: 847-483-7447
Mailing address:
  • Phone: 847-870-4780
  • Fax: 847-483-7447

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. BETH W TZE
Title or Position: CHEIF EXECUTIVE OFFICER
Credential: CEO
Phone: 847-385-7321