Organization
INGALLS PROVIDER GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LYNN PHILIPSON (PRESIDENT)
(708) 915-6135
Entity
Organization
Contact information
Practice address
4415 HARRISON ST, SUITE 300, C-O NORTH AMERICAN MEDICAL MANAGEMENT, HILLSIDE, IL 60162-1910
(708) 432-4000
(708) 432-4077
Mailing address
4415 HARRISON ST, SUITE 300, C-O NORTH AMERICAN MEDICAL MANAGEMENT, HILLSIDE, IL 60162-1910
(708) 432-4000
(708) 432-4077
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
—
Other
Enumeration date
12/18/2006
Last updated
08/22/2020
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