MEDICARE: DOCTORS ON SITE, LTD

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	208D00000X	General Practice Physician

General Provider Information

NPI Number	:	1720410483
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DOCTORS ON SITE, LTD

Provider Business Mailing Address
First Line	:	1 EXECUTIVE CT
Second Line	:	SUITE 1
City	:	SOUTH BARRINGTON
State	:	IL
Zip	:	60010-9533
Country	:	US
Telephone Number	:	847-882-2030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1 EXECUTIVE CT
Second Line	:	SUITE 1
City	:	SOUTH BARRINGTON
State	:	IL
Zip	:	60010-9533
Country	:	US
Telephone Number	:	847-882-2030
Fax Number	:	847-294-1954

Authorized Official
Title or Position	:	PRESIDENT
Name	:	ROSEANN GAGER
Credential	:
Telephone Number	:	847-882-2030

Provider Enumeration Date	:	08/05/2013
Last Update Date	:	04/28/2017

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