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NPI Code Detail

MEDICARE: STATCARE PC

MEDICARE: STATCARE PC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1CH3766OTHERMIRAILROAD MEDICARE

General Provider Information

NPI Number : 1255333498
Entity Type Code : Organization
Provider Name (Legal Business Name) : STATCARE PC
Provider Business Mailing Address
First Line : DEPT CH 17767
Second Line :
City : PALATINE
State : IL
Zip : 60055-0001
Country : US
Telephone Number : 800-968-6866
Fax Number : 616-532-7230
Provider Business Practice Location Address
First Line : 1 GENESYS PKWY
Second Line :
City : GRAND BLANC
State : MI
Zip : 48439-8065
Country : US
Telephone Number : 800-968-6866
Fax Number : 616-532-7230
Authorized Official
Title or Position : OWNER/PRESIDENT
Name : MICHAEL JULE
Credential : DO
Telephone Number : 810-606-6137
Provider Enumeration Date : 06/01/2005
Last Update Date : 01/14/2008

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Directions to “STATCARE PC ” Practice Location

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