# I2 MEDICINE LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** I-Squared Medical Group
- **Organization subpart:** No

## Provider details

- **NPI number:** 1912559303
- **Authorized official:** DOMINIC D PATAWARAN MD (CO-OWNER)
- **Authorized official phone:** (773) 490-5611

## Contact information

- **Practice address:** 1100 LAKE ST STE 125, OAK PARK, IL 60301-6702
- **Practice address phone:** (773) 490-5611
- **Practice address fax:** (312) 276-8684
- **Mailing address:** PO BOX 25816, CHICAGO, IL 60625-8616
- **Mailing address phone:** (773) 490-5611
- **Mailing address fax:** (312) 276-8684

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | — |
| 207Q00000X | Family Medicine Physician | — | — | — |
| 207R00000X | Internal Medicine Physician | — | NULL | Yes |
| 207R00000X | Internal Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2019
- **Last updated:** 07/15/2019