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Organization
PROGRESSIVE MEDICAL CENTER SC
Active
Organization
PROGRESSIVE MEDICAL CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GABRIELA HENRIQUEZ (OFFICE MANAGER)
(630) 238-9235
Entity
Organization
Contact information
Practice address
1841 W ARMY TRAIL RD, ADDISON, IL 60101-1901
(630) 238-9235
(630) 238-0426
Mailing address
229 W GRAND AVENUE, SUITE R, BENSENVILLE, IL 60106-3365
(630) 238-9235
(630) 238-0426
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036103673
IL
207R00000X
Internal Medicine Physician
Primary
036087152
IL
208000000X
Pediatrics Physician
036078267
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02205538
BCBS GROUP NUMBER
IL
05
—
036078267
—
IL
05
—
036087152
—
IL
05
—
036103673
—
IL
05
—
036109448
—
IL
Enumeration date
11/17/2006
Last updated
08/02/2024
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