NPI 1376270843

Premier Suburban Medical Group, PLLC

Organisation Non-Pharmacy Dispensing Site Orland Park, IL

Practice location

Address: 17047 La Grange Rd., Orland Park, IL 60487-1913
Phone: (815) 300-7764
Mailing address: 1900 Silver Cross Blvd, New Lenox, IL 60451-9509

Authorised official

Name: Refat Baridi
Title: Physician
Phone: (815) 300-7764

Registered specialties

Non-Pharmacy Dispensing Site Primary

Suppliers Taxonomy 332900000X

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Registry record

NPI: 1376270843
Entity type: Organization
NPI issued: 4 Aug 2022
Record last updated: 31 Jul 2024

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.