Organization
EDWARD HEALTH VENTURES
Active
Other names
Edward Medical Group
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM G. KOTTMAN (PRESIDENT)
(630) 646-3950
Entity
Organization
Contact information
Practice address
6701 US HIGHWAY 34, OSWEGO, IL 60543-9129
(630) 646-4255
(630) 646-4256
Mailing address
6701 US HIGHWAY 34, OSWEGO, IL 60543-9129
(630) 646-4255
(630) 646-4256
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2221474
BCBS OF ILLINOIS
IL
Enumeration date
03/07/2008
Last updated
03/27/2009
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