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Organization
PIONEER PHYSICIANS S C
Active
Organization
PIONEER PHYSICIANS S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ADRIANNE ALLEN (BILLER)
(708) 907-3422
Entity
Organization
Contact information
Practice address
7124 W 83RD ST, BRIDGEVIEW, IL 60455-4034
(708) 907-3422
(708) 907-3586
Mailing address
7124 W 83RD ST, BRIDGEVIEW, IL 60455-4034
(708) 907-3422
(708) 907-3586
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F400115929
MEDICARE PTAN
IL
Enumeration date
02/02/2016
Last updated
02/02/2016
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