Organization
MIDWEST MA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
HOWARD S KONOWITZ MD (MANAGING PARTNER)
(847) 921-9733
Entity
Organization
Contact information
Practice address
4650 SOUTHWEST HWY, OAK LAWN, IL 60453-1836
(708) 424-3201
Mailing address
1121 LAKE COOK ROAD, SUITE M, DEERFIELD, IL 60015-5234
(847) 945-4550
(847) 948-8103
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632977
BCBS IL
IL
Enumeration date
07/14/2006
Last updated
08/22/2020
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