MIDWEST PHYSICIAN GROUP LTD (NPI# 1285771972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1285771972 |
| Entity Type | Organization |
| Organization Name | MIDWEST PHYSICIAN GROUP LTD |
| Other Organization Name | MIDWEST PHYSICIAN CENTER OF HOMEWOOD GLENWOOD |
| Practice Address |
4001 Vollmer Rd Olympia Fields IL 60461 |
| Mailing Address |
20110 Governors Hwy Olympia Fields IL 60461-1030 |
| Practice Telephone | 7084818883 |
| Practice Fax Number | 7084812917 |
| Mailing Telephone | 7087477960 |
| Mailing Fax Number | 7085033993 |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2007-08-09 |
| Authorized Official Name | DEBORAH J NELSON (CEO) |
| Authorized Official Telephone | 7087477960 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IL | BCBS | 0001616617 | 01 |
| Other Name | Type Code |
|---|---|
| MIDWEST PHYSICIAN CENTER OF HOMEWOOD GLENWOOD | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942494174 | Midwest Physician Group Ltd | Clinic/Center | 1051 Essington Road, Silver Cross Medical Center, Joliet, IL 60931 | 2007-08-30 |
| 1215074026 | Midwest Physician Group Ltd | Family Medicine | 13811 Cicero Ave, Crestwood, IL 60445-1826 | 2007-01-31 |
| 1053599167 | Midwest Physician Group Ltd | Clinic/Center | 20110 Governors Hwy, 1st Floor, Olympia Fields, IL 60461-1030 | 2008-01-31 |
| 1790976231 | Midwest Physician Group Ltd | Nurse Practitioner | 3800 W 203rd St, Olympia Fields, IL 60461-1184 | 2007-08-08 |
| 1104944214 | Midwest Physician Group Ltd | Clinic/Center | 4001 Vollmer Road, Olympia Fields, IL 60461 | 2007-03-27 |
| 1073650818 | Midwest Physician Group Ltd | Family Medicine | 595 William R Latham Sr Dr, Bourbonnais, IL 60914-2319 | 2007-01-31 |
| 1972640654 | Midwest Physician Group Ltd | Internal Medicine | 3800 W 203rd St, Suite 202, Olympia Fields, IL 60461-1184 | 2007-01-31 |
| 1073650560 | Midwest Physician Group Ltd | Family Medicine | 11250 S Western Ave, Chicago, IL 60643-4116 | 2007-01-31 |
| 1699812487 | Midwest Physician Group Ltd | Family Medicine | 3201 S Wallace St, Chicago, IL 60616-3501 | 2007-01-31 |
| 1639216435 | Midwest Physician Group Ltd | Family Medicine | 10242 S Vincennes Ave, Chicago, IL 60643-1301 | 2007-01-31 |
| Street Address |
4001 VOLLMER RD |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467405472 | Julie R Brandies | Internal Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2006-05-19 |
| 1962053413 | Cherlonda Howard | Family Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2019-09-26 |
| 1508301656 | Michael Alagna | Nurse Practitioner | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2016-12-28 |
| 1326412941 | Meghan Hagan | Nurse Practitioner | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2015-11-19 |
| 1619135233 | Samuel J Multack | Ophthalmology | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2008-05-30 |
| 1598949760 | Don T Martinez Jr. | Physician Assistant | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2007-12-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609372564 | Katherine Gill Haddad | Student in an Organized Health Care Education/Training Program | 20201 S. Crawford Avenue, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2018-03-31 |
| 1750886610 | Kim Minh Dang | Student in an Organized Health Care Education/Training Program | 20201 South Crawford, Olympia Fields, IL 60461 | 2018-03-23 |
| 1619484110 | Alexandra N. Douvas | Dentist | 20180 Governors Hwy, Ste 104, Olympia Fields, IL 60461 | 2018-01-05 |
| 1992258438 | Krystyne Doty | Nurse Practitioner | 3800 W 203rd St Ste 209, Olympia Fields, IL 60461 | 2016-08-02 |
| 1205286747 | Shirlene Umali | Registered Nurse | 20201 South Crawford Ave, Olympia Fields, IL 60461 | 2016-06-15 |
| 1386002590 | Touch of Wholeness Psychological Services, LLC | Psychologist | 20280 Governors Dr, Suite 207, Olympia Fields, IL 60461 | 2016-02-02 |
| 1063895357 | David Dardick | Dentist | 20180 Governors Hwy Ste 104, Olympia Fields, IL 60461 | 2015-07-04 |
| 1811378623 | Fins Healthcare Agency | Nursing Care | 3612 Lincohn Highway, Suite 19, Olympia Fields, IL 60461 | 2015-06-17 |
| 1285048959 | Garud Ranga Raj | Orthopaedic Surgery | 20817 Alexander St, Olympia Fields, IL 60461 | 2014-06-20 |
| 1811316334 | Brett Hapeman | Emergency Medicine | 20201 S Crawford, Attn: Postdoctoral Education, Olympia Fields, IL 60461 | 2014-04-11 |
| Find all providers in zip 60461 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699129932 | Marie Michele Baird | Family Medicine | 3700 W 203rd St Ste 301, Olympia Fields, IL 60461-1182 | 2016-04-22 |
| 1891112306 | William Seng Tan | Family Medicine | 20060 Governors Dr Ste 204, Olympia Fields, IL 60461-1099 | 2014-03-21 |
| 1083826713 | Burke Medical Group Ltd | Family Medicine | 3700 W 203rd Street, Suite 310, Olympia Fields, IL 60461-1182 | 2007-05-04 |
| 1467405985 | Midwest Physician Group Ltd. | Family Medicine | 20110 Governors Hwy, Suite 1, Olympia Fields, IL 60461-1030 | 2006-05-18 |
| 1962452193 | Rita N Oganwu | Family Medicine | 203030 S. Crawford Ave Ste 110, Olympia Fields, IL 60461 | 2006-05-10 |
| 1316943848 | Kathryn R Burke | Family Medicine | 3700 W 203rd St, Ste 310, Olympia Fields, IL 60461-1182 | 2005-06-21 |
| 1790780344 | Robert C Watkins Jr. | Family Medicine | 2555 Lincoln Hwy, Suite 206, Olympia Fields, IL 60461-1936 | 2005-06-20 |
| 1962053413 | Cherlonda Howard | Family Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461-3168 | 2019-09-26 |
| 1588169379 | Rushabh Shah | Family Medicine | 20201 Crawford Ave, Olympia Fields, IL 60461-1010 | 2018-03-26 |
| 1831622141 | Mohammad Wadud | Family Medicine | 3700 W 203rd St Ste 301, Olympia Fields, IL 60461-1182 | 2017-04-04 |
| Find all providers in OLYMPIA FIELDS | ||||
| City | OLYMPIA FIELDS |
| Zip Code | 60461 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.