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Organization
TLC MEDICAL GROUP, S.C.
Active
Organization
TLC MEDICAL GROUP, S.C.
Active
Other names
TLC Womens Health, S.C./TLC Pediatrics, S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
ESTHER IM KAY (PRACTICE MANAGER)
(630) 513-9160
Entity
Organization
Contact information
Practice address
2455 DEAN ST, SUITE A, SAINT CHARLES, IL 60175-4830
(630) 513-9160
(630) 513-9617
Mailing address
2455 DEAN ST, SUITE A, SAINT CHARLES, IL 60175-4830
(630) 513-9160
(630) 513-9617
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
036106052
IL
208000000X
Pediatrics Physician
Primary
036104024
IL
208000000X
Pediatrics Physician
036121171
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36104024
—
IL
01
—
4532123
BCBS
IL
Enumeration date
12/20/2006
Last updated
12/28/2009
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