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Organization
SOUTHWEST MEDICAL AFFILIATES, PC
Active
Organization
SOUTHWEST MEDICAL AFFILIATES, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON L MORIARTY (FINANCIAL SPECIALIST)
(708) 857-5804
Entity
Organization
Contact information
Practice address
5630 111TH ST, CHICAGO RIDGE, IL 60415-2406
(708) 857-5800
(708) 857-5805
Mailing address
5630 111TH ST, CHICAGO RIDGE, IL 60415-2406
(708) 857-5800
(708) 857-5805
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036063034
IL
208000000X
Pediatrics Physician
036063793
IL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
016004378
IL
Other
Enumeration date
05/02/2007
Last updated
11/20/2012
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