MEDICARE: MARANATHA FAMILY MEDICINE

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	207Q00000X	Family Medicine Physician	036063544	IL

General Provider Information

NPI Number	:	1487898417
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MARANATHA FAMILY MEDICINE

Provider Business Mailing Address
First Line	:	550 N MIDLOTHIAN RD
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1613
Country	:	US
Telephone Number	:	847-949-8474
Fax Number	:	847-949-4825

Provider Business Practice Location Address
First Line	:	550 N MIDLOTHIAN RD
Second Line	:
City	:	MUNDELEIN
State	:	IL
Zip	:	60060-1613
Country	:	US
Telephone Number	:	847-949-8474
Fax Number	:	847-949-4825

Authorized Official
Title or Position	:	OWNER
Name	:	DR. CHESTER GREGORY LASKOWSKI
Credential	:	M.D.
Telephone Number	:	847-949-8474

Provider Enumeration Date	:	04/21/2009
Last Update Date	:	04/21/2009

Similar Medicare Providers

1851384200 — CHHAYA CHANDEL M.D
Practice Location Address:

550 N MIDLOTHIAN RD , # 400
MUNDELEIN, IL
60060-1613

Practice Phone: 847-837-1923
Practice Fax: 847-837-1924

1093702243 — DR. EDWARD ARTHUR SCHULZ DPM
Practice Location Address:

550 N MIDLOTHIAN RD , STE 100
MUNDELEIN, IL
60060-1613

Practice Phone: 847-566-9030
Practice Fax: 847-566-9034

1134328123 — ANCHOR PEDIATRICS
Practice Location Address:

550 N MIDLOTHIAN RD , SUITE 400
MUNDELEIN, IL
60060-1613

Practice Phone: 847-837-1923
Practice Fax: 847-837-1924

1003352071 — INTEGRATED WELLNESS CENTER
Practice Location Address:

550 N MIDLOTHIAN RD , SUITE 300
MUNDELEIN, IL
60060-1613

Practice Phone: 847-445-1178
Practice Fax: 224-778-5491

1821940503 — EVERWELL WOUND CARE PROFESSIONAL LLC
Practice Location Address:

27353 N OAKLEAF CT
MUNDELEIN, IL
60060-9580

Practice Phone: 888-383-7931
Practice Fax: 888-383-7991

1073468401 — OLIVIA NORTILLO CLARK LSW, MSW
Practice Location Address:

1445 CANTERBURY LN APT A208
MUNDELEIN, IL
60060-4457

Practice Phone: 847-212-7622
Practice Fax:

Directions to “MARANATHA FAMILY MEDICINE ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.