Organization
BETHANY HOMES AND METHODIST HOSPITAL
Active
Organization
BETHANY HOMES AND METHODIST HOSPITAL
Active
Other names
LAKEVIEW MEDICAL GROUP
Organization subpart
No
Provider details
NPI number
Authorized official
MR. HAROLD MARSHALL REISLER (CONTROLLER)
(773) 989-1465
Entity
Organization
Contact information
Practice address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
(773) 989-1465
(773) 989-1377
Mailing address
5025 N PAULINA ST, CHICAGO, IL 60640-2772
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
11/12/2009
Last updated
11/12/2009
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