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General NPI Number Information
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NPI Number | 1235328238
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Entity Type | Organization
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Legal Business Name | MARK HARVEY MDSC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 11/02/2007
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Provider Practice Location Address
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Address Line | 7336 S OGLESBY AVE 7906 S CRANDON SUITE #2
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City | CHICAGO
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State | IL
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Zip | 60649-3412
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Country | US
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Telephone | 773-721-8557
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Fax | 773-721-0135
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Provider Business Mailing Address
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Address Line | 7336 S OGLESBY AVE
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City | CHICAGO
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State | IL
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Zip | 60649-3412
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Country | US
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Telephone | 773-721-8557
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Fax | 773-721-0135
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARK HARVEY
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Credential | M.D.
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Telephone | 773-374-0933
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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