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General NPI Number Information
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NPI Number | 1679898415
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Entity Type | Organization
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Legal Business Name | MIDWEST ASSOCIATES IN PRIMARY CARE LTD
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Dates
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Enumeration Date | 04/05/2010
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Last Update Date | 04/05/2010
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Provider Practice Location Address
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Address Line | 8741 S GREENWOOD AVE STE 104
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City | CHICAGO
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State | IL
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Zip | 60619-7058
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Country | US
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Telephone | 773-221-1400
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Fax | 773-221-3258
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Provider Business Mailing Address
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Address Line | PO BOX 805192
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City | CHICAGO
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State | IL
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Zip | 60680-4113
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Country | US
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Telephone | 773-221-1400
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Fax | 773-221-3258
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Authorized Official
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Title or Position | CEO
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Name | DR. CARMELITA ROWENA ROBINSON
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Credential | MD
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Telephone | 773-221-1400
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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 | 042007900
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License Number State | IL
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