Healthcare Provider Details

I. General information

NPI: 1225750193
Provider Name (Legal Business Name): DELTA MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/16/2022
Last Update Date: 06/23/2023
Certification Date: 06/23/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S NELTNOR BLVD
WEST CHICAGO IL
60185-2847
US

IV. Provider business mailing address

PO BOX 578220
CHICAGO IL
60657-7303
US

V. Phone/Fax

Practice location:
  • Phone: 773-658-0311
  • Fax:
Mailing address:
  • Phone: 773-658-0311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. KALID ADAB
Title or Position: OWNER
Credential: MD
Phone: 773-658-0311