Organization
FOUNTAIN MEDICAL GROUP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EDWIN JOSEPH CAREY MD (PRESIDENT)
(815) 786-2101
Entity
Organization
Contact information
Practice address
15 W PLEASANT AVE, SANDWICH, IL 60548-1050
(815) 786-2101
(815) 786-7745
Mailing address
15 W PLEASANT AVE, SANDWICH, IL 60548-1050
(815) 786-2101
(815) 786-7745
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Enumeration date
02/02/2006
Last updated
08/22/2020
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