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General NPI Number Information
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NPI Number | 1437603453
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Entity Type | Organization
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Legal Business Name | CENTRAL FAMILY CARE & WEIGHT LOSS CLINIC LLC
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Dates
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Enumeration Date | 08/08/2016
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Last Update Date | 03/14/2023
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Provider Practice Location Address
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Address Line | 3335 N ARLINGTON HEIGHTS RD STE G-K
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City | ARLINGTON HEIGHTS
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State | IL
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Zip | 60004-1573
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Country | US
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Telephone | 224-347-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 15 OLD BARN RD
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City | HAWTHORN WOODS
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State | IL
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Zip | 60047-9149
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Country | US
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Telephone | 773-822-2564
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | JANUSZ A MEJER
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Credential | MD
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Telephone | 773-822-2564
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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 | IL
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