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General NPI Number Information
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NPI Number | 1376661199
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Entity Type | Organization
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Legal Business Name | POPLAR CREEK FAMILY PRACTICE
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Dates
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Enumeration Date | 03/27/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1555 BARRINGTON RD SUITE 3450
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60194-1019
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Country | US
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Telephone | 847-882-2400
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Fax | 847-884-7222
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Provider Business Mailing Address
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Address Line | 1555 BARRINGTON RD SUITE 3450
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City | HOFFMAN ESTATES
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State | IL
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Zip | 60194-1019
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Country | US
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Telephone | 847-882-2400
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Fax | 847-884-7222
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | ELIZABETH J LANDS
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Credential |
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Telephone | 847-882-2400
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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