Komprehensive Primary Care Sports & Musculoskeletal Medicine S.C.

Key facts

NPI: 1285966440
Entity type: Organization (NPI type 2)
Primary specialty: Sports Medicine (Family Medicine) Physician 207QS0010X
License: 036114281 (IL)
Legal business name: KOMPREHENSIVE PRIMARY CARE SPORTS & MUSCULOSKELETAL MEDICINE S.C.
Practice address: 2813 W 147TH St
Posen, IL 60469-1516
Phone: (708) 396-9777
Fax: (708) 396-9732
NPI assigned: Feb 12, 2010
Organization subpart: No

Authorized official

Name: Dr. Michael G Ward, MD NPI 1710953070
Title: President
Phone: (312) 420-3445

Authorized official NPPES reports the authorized official by name only; the link goes to the one practitioner connected to this organization with that name.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Michael G. Ward, M.D. Sports Medicine (Family Medicine) Physician · Hoffman Estates, IL · NPI 1710953070

Medicare reassignment Authorized official IL
Pamela P Kontos, NP Acute Care Nurse Practitioner · Homewood, IL · NPI 1972855989

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Enrolled in IL

Medicare enrollment records

Enrollment ID	State	Provider type	PAC ID	Details
O20101210000518	IL	Part B Supplier - Clinic/Group Practice	2961699335	Receives reassigned benefits from 1 practitioner Practice locations: Homewood, IL

National Provider Directory

Locations

17600 Kedzie Ave
Hazel Crest, IL 60429

18350 Kedzie Ave
Ste 100
Homewood, IL 60430
Phone (708) 365-1055

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Sports Medicine (Family Medicine) Physician Group: 193400000X SINGLE SPECIALTY GROUP	207QS0010X	036114281	IL	Yes

Addresses

Primary practice location

2813 W 147TH St
Posen, IL 60469-1516

Mailing address

845 E 40TH St
Chicago, IL 60653-2444
Phone (312) 420-3445

Other providers in Posen, IL

Peter Erickson, PHARM.D.
Danielle Nicole Gilmore, M.H.S., CFY-SLP
Zoila Gutierrez
Heal-Thy People Family Care Center LTD
Heal-Thy People Ministries Inc.
Patricia Ann Lietzow
Latanya Morris, PA-C
N J Amin
Posen-Robbins El SCH Dist 1435
Teanna Shambrae Ramirez, MSW

All providers in Posen, IL · Sports Medicine (Family Medicine) Physician in Illinois

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 12, 2010. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.