Organization
MIDWEST PHYSICIAN GROUP LTD
Active
Parent organization
MIDWEST PHYSICIAN GROUP LTD
Other names
MPC-PHYSICAL THERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
MIDWEST PHYSICIAN GROUP LTD
Authorized official
DEBORAH J NELSON (CEO)
(708) 747-7960
Entity
Organization
Contact information
Practice address
20110 GOVERNORS HWY, 1ST FLOOR, OLYMPIA FIELDS, IL 60461-1030
(708) 747-7960
(708) 503-3993
Mailing address
20110 GOVERNORS HWY, 1ST FLOOR, OLYMPIA FIELDS, IL 60461-1030
(708) 747-7960
(708) 503-3993
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01616617
BCBS
IL
Enumeration date
01/31/2008
Last updated
01/31/2008
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