# PRESTON HEALTH PARTNERS P C

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- **Entity:** Organization
- **Status:** Active
- **Other names:** PRESTON FAMILY PRACTICE
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275726085
- **Authorized official:** DR. REBECCA C PRESTON MD (OWNER)
- **Authorized official phone:** (708) 784-9000

## Contact information

- **Practice address:** 4479 CENTRAL AVE, WESTERN SPRINGS, IL 60558-1714
- **Practice address phone:** (708) 784-9000
- **Practice address fax:** (708) 784-9088
- **Mailing address:** 4479 CENTRAL AVE, WESTERN SPRINGS, IL 60558-1714
- **Mailing address phone:** (708) 784-9000
- **Mailing address fax:** (708) 784-9088

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261Q00000X | Clinic/Center | 036080973 | IL | Yes |

## Other

- **Enumeration date:** 08/24/2007
- **Last updated:** 03/19/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0021605429 | BLUE CROSS BLUE SHIELD | IL |
| 05 | — | 036080973 | — | IL |
| 01 | — | 50780 | TRICARE | IL |