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Organization

MIDWEST PHYSICIAN GROUP LTD

Active
Parent organization
MIDWEST PHYSICIAN GROUP LTD
Other names
MARITTA A PENEGOR CFNP
Organization subpart
Yes

Provider details

NPI number
Legal business name
MIDWEST PHYSICIAN GROUP LTD
Authorized official
DEBORAH J NELSON (CEO)
(708) 747-7960
Entity
Organization

Contact information

Practice address
3800 W 203RD ST, OLYMPIA FIELDS, IL 60461-1184
(708) 747-0461
(708) 747-0607
Mailing address
20110 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1030
(708) 747-7960
(708) 503-3993

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
IL

Other

Enumeration date
08/08/2007
Last updated
08/09/2007
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