MEDICARE: ALL CARE MEDICAL CENTER

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
1	207R00000X	Internal Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004515212	OTHER	IL	BCBS ID

General Provider Information

NPI Number	:	1295933067
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALL CARE MEDICAL CENTER

Provider Business Mailing Address
First Line	:	650 SPRING HILL RING RD
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1296
Country	:	US
Telephone Number	:	847-428-2273
Fax Number	:

Provider Business Practice Location Address
First Line	:	650 SPRING HILL RING RD STE 2000
Second Line	:
City	:	WEST DUNDEE
State	:	IL
Zip	:	60118-1297
Country	:	US
Telephone Number	:	847-428-2273
Fax Number	:

Authorized Official
Title or Position	:	BILLING AGENT
Name	:	PETER E SMITH
Credential	:
Telephone Number	:	815-965-8505

Provider Enumeration Date	:	07/03/2007
Last Update Date	:	08/22/2020

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Directions to “ALL CARE MEDICAL CENTER ” Practice Location

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