TOTAL CARE MEDICAL CLINIC NPI 1548447956

NPI Information

TOTAL CARE MEDICAL CLINIC is an addiction medicine family medicine in Berwyn, IL. The provider is a family medicine physician who specializes in the diagnosis and treatment of addictions. TOTAL CARE MEDICAL CLINIC NPI is 1548447956. The provider is registered as an organization entity type and is a single specialty group.
The provider Former Legal Business Name Is Total Care Medical Group.

The provider's business location address is:

6929 OGDEN AVE
BERWYN, IL
ZIP 60402-649
Phone: (708) 484-9472
Fax: (708) 484-9473

The provider's authorized official is Leonard M Spishakoff .
The authorized official title is Physician and has the following contact phone number (708) 484-9506.

The CLIA number assigned to this NPI record is 14D0994433 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/28/2008 and was last updated on 4/13/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

Other Identifiers

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