Organization
MACNEAL PHYSICIANS GROUP LLC
Active
Other names
Vanguard Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
CRAIG C. ARMIN (VP OF GOVT PROGRAMS, TENET)
(818) 436-2267
Entity
Organization
Contact information
Practice address
3249 OAK PARK AVE, BERWYN, IL 60402-3429
(708) 783-3222
(708) 783-3489
Mailing address
20 BURTON HILLS BLVD, SUITE 100, ATTENTION, CAROL BAILEY, NASHVILLE, TN 37215-6197
(615) 665-6000
(615) 665-6184
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208800000X
Urology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1638562
BCBS - IL
IL
Enumeration date
10/09/2007
Last updated
03/18/2021
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