Organization
FAMILY MEDICAL CLINIC INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERTO CASTRO MD (OWNER)
(847) 439-6803
Entity
Organization
Contact information
Practice address
800 BIESTERFIELD RD, 535, ELK GROVE VILLAGE, IL 60007-3311
(847) 439-6803
Mailing address
800 BIESTERFIELD RD, 535, ELK GROVE VILLAGE, IL 60007-3311
(847) 439-6803
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
36094399
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094399
—
IL
Enumeration date
06/22/2006
Last updated
08/12/2008
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