Organization
FAMILY MEDICINE SPECIALISTS, INC
Active
Parent organization
FAMILY MEDICINE SPECIALISTS, INC
Organization subpart
Yes
Provider details
NPI number
Legal business name
FAMILY MEDICINE SPECIALISTS, INC
Authorized official
JENNIFER BELLUCI-JACKSON M.D. (MEDICAL DIRECTOR)
(847) 526-2151
Entity
Organization
Contact information
Practice address
431 W LIBERTY ST, WAUCONDA, IL 60084-2452
(847) 526-2151
Mailing address
2980 N BEVERLY GLEN CIR, SUITE 301, LOS ANGELES, CA 90077-1726
(310) 474-9809
(888) 652-3017
Taxonomy
Speciality
Code
Description
License number
State
332900000X
Non-Pharmacy Dispensing Site
Primary
—
—
Other
Enumeration date
03/17/2010
Last updated
03/01/2011
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