Solid Rock Care Center II

Organization Active NPI General Practice Physician · Oak Park, IL

NPI 1780877993 · NPPES record last updated Aug 13, 2008

Key facts

NPI
1780877993
Entity type
Organization (NPI type 2)
Primary specialty
General Practice Physician 208D00000X
Legal business name
SOLID ROCK CARE CENTER II
Practice address
228 Madison St
Oak Park, IL 60302-4194
Phone
(708) 358-8040
Fax
(708) 358-8049
NPI assigned
Aug 21, 2007
Organization subpart
No

Authorized official

Name
Mr. Larry Smith
Title
Ceo
Phone
(708) 358-8040

Practitioners 12

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

National Provider Directory

Locations

228 Madison St
Oak Park, IL 60302
Phone (708) 358-8040

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician
Group: 193400000X SINGLE SPECIALTY GROUP
208D00000X Yes

Addresses

Primary practice location

228 Madison St
Oak Park, IL 60302-4194

Mailing address

228 Madison St
Oak Park, IL 60302-4194
Phone (708) 358-8040

Other identifiers

IdentifierTypeStateIssuer
6030201MedicaidIL

Other providers in Oak Park, IL

All providers in Oak Park, IL · General Practice Physician in Illinois

Sources for this page

Verify at the official NPI Registry.