Healthcare Provider Details

I. General information

NPI: 1730359993
Provider Name (Legal Business Name): AMR MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2008
Last Update Date: 03/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 ACADEMY DR
NORTHBROOK IL
60062-2420
US

IV. Provider business mailing address

609 ACADEMY DR
NORTHBROOK IL
60062-2420
US

V. Phone/Fax

Practice location:
  • Phone: 847-537-5555
  • Fax: 847-537-6005
Mailing address:
  • Phone: 847-537-5555
  • Fax: 847-537-6005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: LISA ANDERSON
Title or Position: MANAGER
Credential:
Phone: 84753755555