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General NPI Number Information
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NPI Number | 1003177320
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Entity Type | Organization
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Legal Business Name | MEDICAL ACCESS GROUP INC
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Dates
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Enumeration Date | 06/04/2012
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Last Update Date | 06/04/2012
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Provider Practice Location Address
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Address Line | 10001 W ROOSEVELT RD SUITE 224
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City | WESTCHESTER
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State | IL
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Zip | 60154-2664
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Country | US
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Telephone | 708-356-4300
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Fax | 708-356-4301
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Provider Business Mailing Address
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Address Line | 10001 W ROOSEVELT RD SUITE 224
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City | WESTCHESTER
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State | IL
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Zip | 60154-2664
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Country | US
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Telephone | 708-356-4300
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Fax | 708-356-4301
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Authorized Official
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Title or Position | MANAGER
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Name | VELMA SMITH
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Credential |
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Telephone | 708-356-4300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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