# MIDWAY PHYSICIAN GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174741417
- **Authorized official:** KENJI OYASU MD (MEDICAL DIRECTOR)
- **Authorized official phone:** (847) 360-4023

## Contact information

- **Practice address:** 1324 N SHERIDAN RD, WAUKEGAN, IL 60085-2161
- **Practice address phone:** (847) 360-4181
- **Mailing address:** 1840 NORTHWOOD LN, WAUCONDA, IL 60084-5044
- **Mailing address phone:** (847) 487-1839

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 282N00000X | General Acute Care Hospital | — | IL | Yes |

## Other

- **Enumeration date:** 04/23/2007
- **Last updated:** 08/22/2020