NPI 1013415603

Gottlieb Community Health Services Corporation

Organisation General Practice Physician Berwyn, IL

Practice location

Address: 3249 Oak Park Ave, Berwyn, IL 60402-3429
Phone: (708) 783-3125
Mailing address: 2160 S 1st Ave Bldg 102, Maywood, IL 60153-3328

Authorised official

Name: Adenrele Kolawole
Title: Director Billing Operations
Phone: (708) 216-3743

Registered specialties

General Practice Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208D00000X

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Registry record

NPI: 1013415603
Entity type: Organization
NPI issued: 29 Jan 2018
Record last updated: 16 Jun 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.