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General NPI Number Information
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NPI Number | 1427244029
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Entity Type | Organization
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Legal Business Name | UNITED MEDICAL GROUP, SC
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 04/29/2014
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Provider Practice Location Address
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Address Line | 5301 DEMPSTER ST STE 205
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City | SKOKIE
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State | IL
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Zip | 60077-1846
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Country | US
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Telephone | 847-470-9911
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Fax | 847-470-9966
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Provider Business Mailing Address
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Address Line | 5301 DEMPSTER ST STE 205
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City | SKOKIE
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State | IL
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Zip | 60077-1846
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Country | US
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Telephone | 847-470-9911
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Fax | 847-470-9966
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Authorized Official
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Title or Position | PRESIDENT
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Name | MR. DMITREY GEORGE STEBLEY
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Credential |
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Telephone | 847-471-9911
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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 |
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