Organization
FAMILY HEALTH AND FITNESS SPECIALISTS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MATTHEW BRANDON (PRESIDENT)
(847) 622-0506
Entity
Organization
Contact information
Practice address
455 BRIARGATE DR, SOUTH ELGIN, IL 60177-2225
(847) 622-0506
(847) 622-0507
Mailing address
455 BRIARGATE DR, SOUTH ELGIN, IL 60177-2225
(847) 622-0506
(847) 622-0507
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036105926
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105926 3
—
IL
01
—
4532366
BCBS
IL
Enumeration date
08/12/2006
Last updated
07/10/2013
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