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General NPI Number Information
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NPI Number | 1942535661
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Entity Type | Organization
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Legal Business Name | AMERICAN PHYSICIANS ASSOCIATES LTD
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Dates
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Enumeration Date | 10/14/2009
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Last Update Date | 02/23/2010
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Provider Practice Location Address
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Address Line | 6232 N PULASKI RD SUITE 400
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City | CHICAGO
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State | IL
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Zip | 60646-5132
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Country | US
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Telephone | 773-202-1611
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Fax | 773-202-1711
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Provider Business Mailing Address
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Address Line | 6232 N PULASKI RD SUITE 400
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City | CHICAGO
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State | IL
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Zip | 60646-5132
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Country | US
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Telephone | 773-202-1611
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Fax | 773-202-1711
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Authorized Official
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Title or Position | PRESIDENT
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Name | JACQUELINE BARDWELL
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Credential | M.D.
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Telephone | 773-202-1611
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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 |
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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