MEDICARE: MIDWEST EXPRESS CARE 2, INC

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	261QU0200X	Urgent Care Clinic/Center

General Provider Information

NPI Number	:	1891443321
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MIDWEST EXPRESS CARE 2, INC

Provider Business Mailing Address
First Line	:	PO BOX 775253
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60677-5253
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1122 WILLOW RD
Second Line	:
City	:	NORTHBROOK
State	:	IL
Zip	:	60062-6824
Country	:	US
Telephone Number	:	847-714-1220
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MILAP SHAH
Credential	:
Telephone Number	:	219-802-8800

Provider Enumeration Date	:	03/14/2022
Last Update Date	:	03/14/2022

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Directions to “MIDWEST EXPRESS CARE 2, INC ” Practice Location

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