Organization
PRESTON HEALTH PARTNERS P C
Active
Other names
PRESTON FAMILY PRACTICE
Organization subpart
No
Provider details
NPI number
Authorized official
DR. REBECCA C PRESTON MD (OWNER)
(708) 784-9000
Entity
Organization
Contact information
Practice address
4479 CENTRAL AVE, WESTERN SPRINGS, IL 60558-1714
(708) 784-9000
(708) 784-9088
Mailing address
4479 CENTRAL AVE, WESTERN SPRINGS, IL 60558-1714
(708) 784-9000
(708) 784-9088
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036080973
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0021605429
BLUE CROSS BLUE SHIELD
IL
05
—
036080973
—
IL
01
—
50780
TRICARE
IL
Enumeration date
08/24/2007
Last updated
03/19/2010
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