Organization
ASSOCIATED MEDICAL CENTERS SC
Active
Other names
Beverly Park Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T FOREMAN MD (PRESIDENT)
(773) 947-7746
Entity
Organization
Contact information
Practice address
10543 SO WESTERN, ST 102, CHICAGO, IL 60643
(773) 298-0990
(773) 445-1364
Mailing address
10543 SO WESTERN, ST 102, CHICAGO, IL 60643
(773) 298-0990
(773) 445-1364
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630236
BCBS
IL
Enumeration date
04/10/2007
Last updated
08/22/2020
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