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Organization
MEDICAL CARE CENTER OF LAKE VILLA
Active
Organization
MEDICAL CARE CENTER OF LAKE VILLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MOHAMED E NASR M.D. (PHYSICIAN AND SURGEON)
(847) 356-9009
Entity
Organization
Contact information
Practice address
213 S MILWAUKEE AVE, LAKE VILLA, IL 60046-8551
(847) 356-9009
Mailing address
213 S MILWAUKEE AVE, LAKE VILLA, IL 60046-8551
(847) 356-9009
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036047948
IL
207Q00000X
Family Medicine Physician
036058768
IL
207Q00000X
Family Medicine Physician
036082737
IL
207R00000X
Internal Medicine Physician
Primary
036047948
IL
207R00000X
Internal Medicine Physician
036058768
IL
207R00000X
Internal Medicine Physician
036082737
IL
2083P0500X
Preventive Medicine/Occupational Environmental Medicine Physician
036058768
IL
2083P0901X
Public Health & General Preventive Medicine Physician
036058768
IL
208600000X
Surgery Physician
036047948
IL
208600000X
Surgery Physician
036058768
IL
208D00000X
General Practice Physician
036047948
IL
208D00000X
General Practice Physician
036058768
IL
208D00000X
General Practice Physician
036082737
IL
Other
Enumeration date
05/10/2007
Last updated
06/21/2018
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