Organization
FOX RIDGE MEDICAL ASSOCIATES, LLC
Active
Organization
FOX RIDGE MEDICAL ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JEFFREY SCOTT TOMLIN MD (PRACTICE OWNER)
(815) 861-5543
Entity
Organization
Contact information
Practice address
3633 MUNICIPAL DR, MCHENRY, IL 60050
(815) 861-5543
Mailing address
3633 MUNICIPAL DR, MCHENRY, IL 60050-5434
(779) 244-3072
(815) 331-8389
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036.092485
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F100494732
PTAN
—
Enumeration date
06/25/2018
Last updated
08/28/2018
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