Healthcare Provider Details

I. General information

NPI: 1396173134
Provider Name (Legal Business Name): COMPLETE MEDICAL CARE, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/14/2013
Last Update Date: 11/12/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3315 ALGONQUIN RD SUITE 100
ROLLING MEADOWS IL
60008-3257
US

IV. Provider business mailing address

PO BOX 369
NEW LENOX IL
60451-0369
US

V. Phone/Fax

Practice location:
  • Phone: 847-788-0700
  • Fax: 847-788-0703
Mailing address:
  • Phone: 847-943-9949
  • Fax: 815-462-4955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QA0401X
TaxonomyAddiction Medicine (Family Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: STANLEY G TOMCZYK
Title or Position: OWNER
Credential: M.D
Phone: 847-788-0700