MEDICARE: AMERICAN PHYSICIANS ASSOCIATES 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	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician

General Provider Information

NPI Number	:	1942535661
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	AMERICAN PHYSICIANS ASSOCIATES LTD

Provider Business Mailing Address
First Line	:	6232 N PULASKI RD
Second Line	:	SUITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60646-5132
Country	:	US
Telephone Number	:	773-202-1611
Fax Number	:	773-202-1711

Provider Business Practice Location Address
First Line	:	6232 N PULASKI RD
Second Line	:	SUITE 400
City	:	CHICAGO
State	:	IL
Zip	:	60646-5132
Country	:	US
Telephone Number	:	773-202-1611
Fax Number	:	773-202-1711

Authorized Official
Title or Position	:	PRESIDENT
Name	:	JACQUELINE BARDWELL
Credential	:	M.D.
Telephone Number	:	773-202-1611

Provider Enumeration Date	:	10/14/2009
Last Update Date	:	02/23/2010

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