NPI 1033121421

Heritage Medical Group LTD

Organisation Specialist Oak Lawn, IL

Practice location

Address: 5660 W 95th St Suite 6, Oak Lawn, IL 60453-2380
Phone: (708) 499-3676
Fax: (708) 499-1792

Authorised official

Name: Maria N Stavrakos
Title: Office Manager
Phone: (708) 499-3676

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X

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Registry record

NPI: 1033121421
Entity type: Organization
NPI issued: 13 Aug 2006
Record last updated: 6 Dec 2007

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.