Organization
METROPOLITAN MEDICAL CONSULTANTS, S.C.
Active
Other names
Vein Care Alternatives
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN PAUL FEDERBUSCH M.D. (PRESIDEN)
(630) 776-4923
Entity
Organization
Contact information
Practice address
2333 W IRVING PARK RD, CHICAGO, IL 60618
(773) 506-7340
(773) 506-7341
Mailing address
832 W OAKDALE AVE APT 3F, CHICAGO, IL 60657-5111
(630) 776-4923
(630) 629-3901
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
02215674
BCBC-IL GRP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
IL
05
—
036056863
—
IL
01
—
787360
MEDICARE GROUP PROV # FOR GROUP NAMED: METROPOLITAN MEDICAL CONSULTANTS, S.C.
IL
Enumeration date
03/13/2007
Last updated
07/29/2014
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