Organization
ASSOCIATED MEDICAL CENTERS SC
Active
Other names
Jackson Park Medical Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL T FOREMAN MD (PRESIDENT)
(773) 947-7746
Entity
Organization
Contact information
Practice address
7531 SO STONY ISLAND, ST 176, CHICAGO, IL 60649
(773) 947-7746
(773) 947-7751
Mailing address
7531 SO STONY ISLAND, ST 176, CHICAGO, IL 60649
(773) 947-7746
(773) 947-7751
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042004703
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01630237
BCBS
IL
Enumeration date
05/07/2007
Last updated
03/11/2011
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