MEDICARE: INTERVENTION ARMS MEDICAL CENTER LLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	208000000X	Pediatrics Physician
2	363A00000X	Physician Assistant
3	207Q00000X	Family Medicine Physician

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1518145176
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INTERVENTION ARMS MEDICAL CENTER LLC

Provider Business Mailing Address
First Line	:	1809 SHERIDAN RD
Second Line	:
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-2235
Country	:	US
Telephone Number	:	847-785-0611
Fax Number	:	847-785-0617

Provider Business Practice Location Address
First Line	:	1809 SHERIDAN RD
Second Line	:
City	:	NORTH CHICAGO
State	:	IL
Zip	:	60064-2235
Country	:	US
Telephone Number	:	847-785-0611
Fax Number	:	847-785-0617

Authorized Official
Title or Position	:	DIRECTOR
Name	:	MS. LISA ANN CHARLES FIELDS
Credential	:
Telephone Number	:	847-785-0611

Provider Enumeration Date	:	02/06/2008
Last Update Date	:	08/27/2025

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Directions to “INTERVENTION ARMS MEDICAL CENTER LLC ” Practice Location

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