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General NPI Number Information
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NPI Number | 1477766186
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Entity Type | Organization
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Legal Business Name | RIVER FOREST MEDICAL ASSOC INC
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 05/06/2008
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Provider Practice Location Address
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Address Line | 7353 NORTH AVE
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City | RIVER FOREST
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State | IL
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Zip | 60305-1278
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Country | US
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Telephone | 708-867-6087
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Fax | 708-867-6032
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Provider Business Mailing Address
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Address Line | 7353 NORTH AVE
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City | RIVER FOREST
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State | IL
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Zip | 60305-1278
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Country | US
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Telephone | 708-867-6087
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Fax | 708-867-6032
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Authorized Official
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Title or Position | PRESIDENT
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Name | WILLIAM J SARANTOS
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Credential | M.D.
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Telephone | 708-867-6087
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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 | 036066094
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License Number State | IL
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