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General NPI Number Information
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NPI Number | 1841360989
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Entity Type | Organization
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Legal Business Name | ALT-MED RESEARCH GROUP
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Dates
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Enumeration Date | 11/08/2006
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1544 NERGE RD
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3673
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Country | US
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Telephone | 847-923-0046
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Fax | 847-923-0047
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Provider Business Mailing Address
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Address Line | 1544 NERGE RD
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City | ELK GROVE VILLAGE
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State | IL
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Zip | 60007-3673
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Country | US
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Telephone | 847-923-0046
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Fax | 847-923-0047
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Authorized Official
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Title or Position | OWNER
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Name | DR. PATRICK B MASSEY
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Credential | M.D. PHD
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Telephone | 847-923-0046
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number |
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License Number State | IL
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