Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days.
Organization
MIDWEST PHYSICIAN GROUP LTD
Active
Organization
MIDWEST PHYSICIAN GROUP LTD
Active
Parent organization
MIDWEST PHYSICIAN GROUP LTD
Other names
MIDWEST PHYSICIAN CENTER OF CRESTWOOD
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST PHYSICIAN GROUP LTD
Authorized official
DEBORAH J NELSON (CEO)
(708) 747-7960
Entity
Organization
Contact information
Practice address
13811 CICERO AVE, CRESTWOOD, IL 60445-1826
(708) 597-4477
(708) 597-4502
Mailing address
20110 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1030
(708) 747-7960
(708) 503-3993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001616617
BCBS
IL
Enumeration date
01/31/2007
Last updated
12/21/2007
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Sign up