Organization
MIDWEST PHYSICIAN NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RITA JUANITA MCGUIRE M.D. (C.E.O)
(708) 204-4385
Entity
Organization
Contact information
Practice address
326 W 64TH ST, CHICAGO, IL 60621-3114
(708) 204-4385
Mailing address
PO BOX 1328, MATTESON, IL 60443-4328
(708) 204-4385
Taxonomy
Speciality
Code
Description
License number
State
313M00000X
Nursing Facility/Intermediate Care Facility
Primary
036090427
IL
Other
Enumeration date
03/11/2010
Last updated
03/11/2010
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