MIDWEST PHYSICIAN GROUP LTD (NPI# 1104944214) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104944214 |
| Entity Type | Organization |
| Organization Name | MIDWEST PHYSICIAN GROUP LTD |
| Other Organization Name | MPC OF OLYMPIA FIELDS |
| Practice Address |
4001 Vollmer Road Olympia Fields IL 60461 |
| Mailing Address |
20110 Governors Hwy Olympia Fields IL 60461-1030 |
| Practice Telephone | 7084818883 |
| Practice Fax Number | 7084812917 |
| Mailing Telephone | 7084818883 |
| Mailing Fax Number | 7084812917 |
| Enumeration Date | 2007-03-27 |
| Last Update Date | 2020-08-22 |
| 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 | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| MPC OF OLYMPIA FIELDS | 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 |
| 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 |
| 1285771972 | Midwest Physician Group Ltd | Family Medicine | 4001 Vollmer Rd, Olympia Fields, IL 60461 | 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 ROAD |
| City | OLYMPIA FIELDS |
| State | IL |
| Zip Code | 60461 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1740394089 | Thomas P Boesen | Obstetrics & Gynecology | 4001 Vollmer Road, Olympia Fields, IL 60461 | 2006-08-17 |
| 1407055312 | Decker Medical Associates Ltd | Family Medicine | 4001 Vollmer Road, Olympia Fields, IL 60461-1073 | 2007-07-12 |
| 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 | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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| 1407453236 | Dirsi, Inc | Clinic/Center | 2112 N Dayton St, Chicago, IL 60614-4302 | 2020-10-05 |
| 1588261770 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 2701 W 68th St Fl 3, Chicago, IL 60629-1813 | 2020-10-01 |
| 1013514298 | Mount Sinai Community Foundation Dba Sinai Medical Group | Clinic/Center | 1500 S Fairfield Ave Fl 4, Chicago, IL 60608-1782 | 2020-10-01 |
| 1841804879 | Chicago Poly Clinic LLC | Clinic/Center | 2446 W Devon Ave, Chicago, IL 60659-1913 | 2020-09-08 |
| 1386258226 | Ortho Spine Surgical LLC | Clinic/Center | 1925 E 95th St Ste 220, Chicago, IL 60617-4710 | 2020-09-08 |
| 1821607425 | Desired Medical Services Incorporated | Clinic/Center | 371 Mackinaw Ave, Calumet City, IL 60409-2524 | 2020-07-29 |
| 1639787823 | Md Infusions, Pllc | Clinic/Center | 666 Dundee Rd Ste 1800, Northbrook, IL 60062-2727 | 2020-07-14 |
| 1407474083 | Staten Family Practice Pllc | Clinic/Center | 500 W Virginia Ave, Gillespie, IL 62033-1025 | 2020-07-09 |
| 1629696679 | Serenity Internal Medicine & Wellness Center | Clinic/Center | 3330 W 177th St # 2d-1, Hazel Crest, IL 60429-2184 | 2020-07-07 |
| Find all providers with the same taxonomy | ||||
| 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.