Healthcare Provider Details

I. General information

NPI: 1063770386
Provider Name (Legal Business Name): MEDPLUS PHYSICIAN PARTNERS I, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2012
Last Update Date: 04/24/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9680 GOLF RD 2ND FLOOR
DES PLAINES IL
60016-1522
US

IV. Provider business mailing address

PO BOX 68726
SCHAUMBURG IL
60168-0726
US

V. Phone/Fax

Practice location:
  • Phone: 847-699-0801
  • Fax: 847-296-5686
Mailing address:
  • Phone: 708-987-3795
  • Fax: 847-352-0423

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: RITA P SALDANHA
Title or Position: MEDICAL DIRECTOR
Credential: M.D.
Phone: 708-987-3795