Healthcare Provider Details

I. General information

NPI: 1245304260
Provider Name (Legal Business Name): SILVER CROSS MEDICAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1051 ESSINGTON RD SUITE 140
JOLIET IL
60435-2801
US

IV. Provider business mailing address

1200 MAPLE RD
JOLIET IL
60432-1439
US

V. Phone/Fax

Practice location:
  • Phone: 815-740-1100
  • Fax: 815-740-4703
Mailing address:
  • Phone: 815-740-1100
  • Fax: 815-740-4703

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOHN KREPPS
Title or Position: VP FINANCE
Credential:
Phone: 815-740-7084