Midwest Physician Group LTD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MIDWEST PHYSICIAN GROUP LTD

Practice address

4001 Vollmer Rd
Olympia Fields, IL 60461

Phone

(708) 481-8883

Fax

(708) 481-2917

NPI assigned

Jan 31, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Deborah J Nelson

Title

Ceo

Phone

(708) 747-7960

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MIDWEST PHYSICIAN CENTER OF HOMEWOOD GLENWOOD Doing business as

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186617600000",
    "number": "1285771972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20110 GOVERNORS HWY",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611030",
            "telephone_number": "708-747-7960",
            "fax_number": "708-503-3993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 VOLLMER RD",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "60461",
            "telephone_number": "708-481-8883",
            "fax_number": "708-481-2917"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDWEST PHYSICIAN GROUP LTD",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-31",
        "last_updated": "2007-08-09",
        "status": "A",
        "authorized_official_last_name": "NELSON",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "708-747-7960"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0001616617",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIDWEST PHYSICIAN CENTER OF HOMEWOOD GLENWOOD",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Midwest Physician Group LTD
• Midwest Physician Group LTD
• Midwest Physician Group LTD
• Midwest Physician Group LTD
• Midwest Physician Group LTD.
• Midwest Physician Group LTD.
• May Miguel, DNP, CRNA

• Family Medicine Physician in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.