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Organization
TERESA MCKENZIE, M.D., LLC
Active
Organization
TERESA MCKENZIE, M.D., LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TERESA MCKENZIE M.D. (OWNER)
(708) 366-4888
Entity
Organization
Contact information
Practice address
7605 1/2 NORTH AVE, RIVER FOREST, IL 60305-1133
(708) 366-4888
Mailing address
7605 1/2 NORTH AVE, RIVER FOREST, IL 60305-1133
(708) 366-4888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036076673
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036076673
—
IL
01
—
1639941
BCBS
IL
01
—
208524
MEDICARE
IL
Enumeration date
06/19/2008
Last updated
01/15/2013
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