MEDICARE: TLC MEDICAL GROUP, S.C.

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	207V00000X	Obstetrics & Gynecology Physician	036106052	IL
2	208000000X	Pediatrics Physician	036121171	IL
3	208000000X	Pediatrics Physician	036104024	IL

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	4532123	OTHER	IL	BCBS

General Provider Information

NPI Number	:	1649334186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	TLC MEDICAL GROUP, S.C.

Provider Business Mailing Address
First Line	:	2455 DEAN ST
Second Line	:	SUITE A
City	:	SAINT CHARLES
State	:	IL
Zip	:	60175-4830
Country	:	US
Telephone Number	:	630-513-9160
Fax Number	:	630-513-9617

Provider Business Practice Location Address
First Line	:	2455 DEAN ST
Second Line	:	SUITE A
City	:	SAINT CHARLES
State	:	IL
Zip	:	60175-4830
Country	:	US
Telephone Number	:	630-513-9160
Fax Number	:	630-513-9617

Authorized Official
Title or Position	:	PRACTICE MANAGER
Name	:	ESTHER IM KAY
Credential	:
Telephone Number	:	630-513-9160

Provider Enumeration Date	:	12/20/2006
Last Update Date	:	12/28/2009

Similar Medicare Providers

1124316039 — THE FAMILY CENTER OF HOPE, INC.
Practice Location Address:

4422 SAINT CHARLES AVE
NEW ORLEANS, LA
70115-4830

Practice Phone: 505-891-3264
Practice Fax: 504-891-1172

1487932497 — MELISSA TORREGANO WATSON LCSW
Practice Location Address:

4422 SAINT CHARLES AVE
NEW ORLEANS, LA
70115-4830

Practice Phone: 504-908-9688
Practice Fax:

1669907564 — LEVELS OF INTENSIVE FAMILY TREATMENT, LLC
Practice Location Address:

4422 SAINT CHARLES AVE
NEW ORLEANS, LA
70115-4830

Practice Phone: 504-891-3264
Practice Fax: 504-891-1172

1407369341 — TRANSFORMED MINDS LLC
Practice Location Address:

4422 SAINT CHARLES AVE
NEW ORLEANS, LA
70115-4830

Practice Phone: 504-249-3628
Practice Fax: 504-891-1172

1104824887 — DR. JEFF T VICTOR D.O.
Practice Location Address:

2455 DEAN ST STE A&B
ST CHARLES, IL
60175-4830

Practice Phone: 630-208-7388
Practice Fax: 630-208-4818

1386642445 — MRS. GINA K. SONG M.D.
Practice Location Address:

2455 DEAN ST , SUITE A
ST CHARLES, IL
60175-4830

Practice Phone: 630-513-9160
Practice Fax: 630-513-9617

Directions to “TLC MEDICAL GROUP, S.C. ” 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.