Organization
ST MARY INTERNAL MEDICINE ASSOCIATES S C
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ASHRAF ASSAAD ISKANDER MD (PRESIDENT)
(815) 609-9480
Entity
Organization
Contact information
Practice address
2320 S ROUTE 59, PLAINFIELD, IL 60586-7756
(815) 609-9480
(815) 609-9482
Mailing address
2320 S ROUTE 59, PLAINFIELD, IL 60586-7756
(815) 609-9480
(815) 609-9482
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036094077
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036094077
—
IL
Enumeration date
04/04/2007
Last updated
11/30/2010
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