Organization
LAKE MI MOBILE DOCTORS P.C.
Active
Other names
Mobile Doctors of Kansas City
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TYSYN CONTRERAS (DIRECTOR OF QUALITY ASSURANCE)
(312) 939-5090
Entity
Organization
Contact information
Practice address
6501 E COMMERCE AVE, SUITE 170, KANSAS CITY, MO 64120-2171
(816) 994-0073
(816) 994-0084
Mailing address
3319 N. ELSTON AVE, SUITE 200, CHICAGO, IL 60618-5811
(773) 751-7200
(773) 583-4401
Taxonomy
Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
05/11/2011
Last updated
10/15/2012
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