Organization
EDWARD HEALTH VENTURES
Active
Other names
Edward Medical Group - Family Practice Crest Hill
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM KOTTMAN (PRESIDENT)
(630) 646-3950
Entity
Organization
Contact information
Practice address
16151 WEBER ROAD, STE 201, CREST HILL, IL 60403-0865
(815) 838-2888
(815) 838-0222
Mailing address
27555 DIEHL ROAD, ENTRANCE B, WARRENVILLE, IL 60555
(630) 646-3950
(630) 548-6832
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
9919630
BCBS
IL
Enumeration date
08/05/2009
Last updated
10/01/2009
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