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General NPI Number Information
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NPI Number | 1396692299
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Entity Type | Organization
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Legal Business Name | PACIC MCD LLC
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Dates
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Enumeration Date | 03/11/2026
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Last Update Date | 03/11/2026
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Provider Practice Location Address
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Address Line | 540 E JEFFERSON ST
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City | IOWA CITY
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State | IA
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Zip | 52245-2477
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Country | US
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Telephone | 319-339-3621
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Fax |
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Provider Business Mailing Address
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Address Line | 921 SHERWOOD DR
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City | LAKE BLUFF
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State | IL
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Zip | 60044-2203
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Country | US
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Telephone | 888-987-1489
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Fax | 224-255-5813
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Authorized Official
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Title or Position | SOLE MBR
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Name | JENS STRAND
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Credential | MD
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Telephone | 888-987-1489
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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