Organization
NORTH SUBURBAN FAMILY PHYSICIANS SC
Active
Other names
North Suburban Family Physicians
Organization subpart
No
Provider details
NPI number
Authorized official
THOMAS MICHAEL MCGOWAN MD (OWNER)
(224) 424-4624
Entity
Organization
Contact information
Practice address
1256 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(224) 424-4624
(224) 424-4631
Mailing address
1252-1256 AMERICAN WAY, LIBERTYVILLE, IL 60048-3936
(224) 424-4624
(224) 424-4631
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036105977
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036105977
LICENSE
IL
Enumeration date
04/29/2016
Last updated
02/12/2019
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