Organization
D.O.C, FAMILY PRACTICE, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CRYSTAL ANN PEOPLES M.D. (PRESIDENT)
(708) 383-6333
Entity
Organization
Contact information
Practice address
6300 ROOSEVELT RD, OAK PARK, IL 60304-2303
(708) 383-6333
(708) 383-6347
Mailing address
PO BOX 2294, OAK PARK, IL 60303-2294
(708) 383-6333
(708) 383-6347
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036075404
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1588775696
MEDICARE
IL
Enumeration date
04/25/2012
Last updated
04/25/2012
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