Organization
MIDWEST PHYSICIAN GROUP LTD
Active
Other names
MPC-CARDIOVASCULAR INSTITUTE
Organization subpart
No
Provider details
NPI number
Authorized official
DEBORAH J NELSON (CEO)
(708) 747-7960
Entity
Organization
Contact information
Practice address
3800 W 203RD ST, SUITE 202, OLYMPIA FIELDS, IL 60461-1184
(708) 747-0461
(708) 747-4704
Mailing address
20110 GOVERNORS HWY, OLYMPIA FIELDS, IL 60461-1030
(708) 747-7960
(708) 503-3993
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0001616617
BCBS
IL
Enumeration date
01/31/2007
Last updated
08/22/2020
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