Family Medical Group, S.C

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

FAMILY MEDICAL GROUP, S.C

Doing business as

Family Medical Group,S.C

Practice address

330 Madison St
Suite 104
Joliet, IL 60435-6565

Phone

(815) 725-3440

Fax

(815) 725-7209

NPI assigned

Jun 11, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Michale Waszak, M.D

Title

Family Practice M.D

Phone

(815) 725-3440

Specialties & licenses 1

Addresses

Other names 1

• Family Medical Group,S.C Doing business as

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

{
    "created_epoch": "1149984000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1932141579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 MADISON ST",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356565",
            "telephone_number": "815-725-3440",
            "fax_number": "815-725-7209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 MADISON ST",
            "address_2": "SUITE 104",
            "city": "JOLIET",
            "state": "IL",
            "postal_code": "604356565",
            "telephone_number": "815-725-3440",
            "fax_number": "815-725-7209"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY MEDICAL GROUP, S.C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "WASZAK",
        "authorized_official_first_name": "MICHALE",
        "authorized_official_title_or_position": "FAMILY PRACTICE M.D",
        "authorized_official_telephone_number": "815-725-3440",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Medical Group,S.C",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Joliet, IL
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• Family Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.