Organization
MIDWEST EMERGENCY ASSOCIATES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN HOLTZCLAW MD (PRESIDENT)
(440) 887-4718
Entity
Organization
Contact information
Practice address
1555 BARRINGTON RD, ST ALEXIUS MEDICAL CENTER, HOFFMAN ESTATES, IL 60194
(847) 843-2000
(630) 734-1560
Mailing address
PO BOX 637542, CINCINNATI, OH 45263-0001
(865) 292-3000
(865) 470-0851
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1437196623
—
IL
01
—
CJ2285
RAILROAD
IL
Enumeration date
05/31/2006
Last updated
09/02/2015
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