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General NPI Number Information
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NPI Number | 1912793688
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Entity Type | Organization
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Legal Business Name | MIDWEST EXPRESS CARE 2, INC
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Dates
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Enumeration Date | 04/17/2025
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Last Update Date | 04/17/2025
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Provider Practice Location Address
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Address Line | 2508 W 94TH ST
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City | EVERGREEN PARK
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State | IL
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Zip | 60805-2818
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Country | US
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Telephone | 708-470-7383
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 775253
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City | CHICAGO
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State | IL
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Zip | 60677-5253
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | CC MANAGER
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Name | JULIE ANN BUSH
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Credential |
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Telephone | 262-496-0361
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State |
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