Ann Medical Center SC
Organization Active NPI Family Medicine Physician · Matteson, IL
NPI 1366483729 · NPPES record last updated Nov 25, 2009
Key facts
- NPI
- 1366483729
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 036-051648 (IL)
- Legal business name
- ANN MEDICAL CENTER SC
- Practice address
- 4647 Lincoln Hwy
Matteson, IL 60443-2319 - Phone
- (708) 747-7720
- Fax
- (708) 915-7239
- NPI assigned
- Jun 9, 2006
- Organization subpart
- No
Authorized official
- Name
- Anjum Hameeduddin, M.D.
- Title
- Owner
- Phone
- (708) 747-7720
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 036-051648 | IL | Yes |
Addresses
Primary practice location
4647 Lincoln Hwy
Matteson, IL 60443-2319
Mailing address
PO Box 250
Matteson, IL 60443-0250
Phone (708) 747-5850
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 036051648 | Medicaid | IL | |
| 1632848 | Other | IL | BCBSIL GROUP # |
Other providers in Matteson, IL
- Elizabeth Anderson
- Katrina Agnes Anderson
- Salonia M Anderson
- Anderson'S Durable Medical Equipment
- Angelcrest Hospice Corp
- Anointed Kindness Ehealth & Wellness PLLC
- Edith Christine Armstrong
- Jataeva Janay Arnold
- Ohimai Asein
- Temitope Adedamola Asein
All providers in Matteson, IL · 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 Nov 25, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.