Organization
PREMIER SUBURBAN MEDICAL GROUP, PLLC
Active
Organization
PREMIER SUBURBAN MEDICAL GROUP, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY OWENS (DIRECTOR OF FINANCE)
(815) 300-7764
Entity
Organization
Contact information
Practice address
17047 LA GRANGE RD., ORLAND PARK, IL 60487-1913
(815) 300-7106
Mailing address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
(815) 300-7106
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
—
Other
Enumeration date
05/07/2021
Last updated
05/31/2024
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