Organization
INDEPENDENT PHYSICIAN GROUP OF ILLINOIS
Active
Other names
OurHealth Physician Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRIC D LEARY M.D. (PRESIDENT)
(312) 504-3389
Entity
Organization
Contact information
Practice address
111 E WACKER DR, SUITE 107, CHICAGO, IL 60601-3713
(866) 434-3255
Mailing address
1135 S GROVE AVE, OAK PARK, IL 60304-1908
(312) 504-3389
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
IL
Other
Enumeration date
02/08/2012
Last updated
02/08/2012
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