Organization
ERICKSON HEALTH MEDICAL GROUP OF ILLINOIS PC
Active
Other names
Sedgebrook Medical Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MATTHEW NARRETT M.D. (EXECUTIVE VP, CMO)
(410) 402-2257
Entity
Organization
Contact information
Practice address
800 AUDUBON WAY, LINCOLNSHIRE, IL 60069-3811
(847) 876-2200
(847) 793-0281
Mailing address
701 MAIDEN CHOICE LN, CATONSVILLE, MD 21228-5968
(410) 402-2257
(410) 402-2264
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207QG0300X
Geriatric Medicine (Family Medicine) Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
—
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
—
—
213E00000X
Podiatrist
—
—
363LA2200X
Adult Health Nurse Practitioner
—
—
363LG0600X
Gerontology Nurse Practitioner
—
—
364SG0600X
Gerontology Clinical Nurse Specialist
—
—
364SP0808X
Psychiatric/Mental Health Clinical Nurse Specialist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932996
BCBS OF IL
—
Enumeration date
07/21/2006
Last updated
08/28/2009
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