Organization
MERIDIAN PHYSICIAN GROUP PLLC
Active
Other names
Meridian Physician Group PLLC
Organization subpart
No
Provider details
NPI number
Authorized official
RAMON FLORES MD (PRINCIPAL OWNER)
(312) 888-9153
Entity
Organization
Contact information
Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(773) 626-4300
Mailing address
155 N MICHIGAN AVE STE 634, CHICAGO, IL 60601-7796
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
2084P0800X
Psychiatry Physician
Primary
—
—
208600000X
Surgery Physician
—
—
208D00000X
General Practice Physician
—
—
213E00000X
Podiatrist
—
—
Other
Enumeration date
06/29/2020
Last updated
11/10/2020
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