Healthcare Provider Details

I. General information

NPI: 1245487172
Provider Name (Legal Business Name): MERCY CARE HEALTH SYSTEMS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2008
Last Update Date: 08/21/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1851 DOUGLAS RD
MONTGOMERY IL
60538-2159
US

IV. Provider business mailing address

1851 DOUGLAS RD
MONTGOMERY IL
60538-2159
US

V. Phone/Fax

Practice location:
  • Phone: 630-844-9900
  • Fax: 630-844-9990
Mailing address:
  • Phone: 630-844-9900
  • Fax: 630-844-9990

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MOHAMMAD SHAFI
Title or Position: PARTNER
Credential: MD
Phone: 773-744-7864