Organization
PIERSON MEDICAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE PIERSON MD (OWNER)
(708) 868-3309
Entity
Organization
Contact information
Practice address
1477 RING RD, CALUMET CITY, IL 60409-5459
(708) 868-3309
(708) 868-3321
Mailing address
1477 RING RD, CALUMET CITY, IL 60409-5459
(708) 868-3309
(708) 868-3321
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036088112
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01634224
BC/BS PROVIDER #
IL
05
—
036088112
—
IL
Enumeration date
08/01/2006
Last updated
05/14/2013
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