Healthcare Provider Details

I. General information

NPI: 1508152745
Provider Name (Legal Business Name): MEDICAL CONNECTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/27/2011
Last Update Date: 06/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25749 SUNNYMERE DR
PLAINFIELD IL
60585-1290
US

IV. Provider business mailing address

25749 SUNNYMERE DRIVE
PLAINFIELD IL
60585
US

V. Phone/Fax

Practice location:
  • Phone: 815-274-3068
  • Fax:
Mailing address:
  • Phone: 815-274-3068
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number041-269538
License Number StateIL

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MS. MARIE GUARE
Title or Position: RN
Credential: RN
Phone: 815-274-3068