Organization
GREATHOUSE MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DEIRDRA GREATHOUSE MD (PRESIDENT)
(708) 264-8463
Entity
Organization
Contact information
Practice address
1890 SILVER CROSS BLVD STE 550, NEW LENOX, IL 60451-9579
(708) 264-8463
Mailing address
1531 DUNBAR ST, FLOSSMOOR, IL 60422-4380
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036114405
IL
Other
Enumeration date
05/04/2017
Last updated
05/04/2017
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