Evergreen Care Center Ltd

LBN: Evergreen Care Center Ltd
Evergreen Care Center Ltd is an health care organization with primary practice located at 9760 S Kedzie Ave Suite 3, Evergreen Park IL 60805-3109. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as the primary health care specialty. Evergreen Care Center Ltd can be contacted via phone (708) 423-6209, or through Joseph, Thomas via phone (708) 423-6209.

Contact Information

Primary practice address
9760 S Kedzie Ave Suite 3 Evergreen Park IL 60805-3109
Phone: (708) 423-6209
Fax: (708) 423-9021
Website:
Map and Directions
Authorized official contact:
Name: Joseph, Thomas Doctor of Medicine (MD)
Phone: (708) 423-6209

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / General Practice 208D00000X

Profile Details

NPI number 1447449616
LBN Legal business name Evergreen Care Center Ltd
DBA Doing business as
Authorized official Joseph, Thomas Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Oct 23rd, 2007
Last updated Jul 19th, 2010 - about 14 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447449616 NPPES
Illinois Other DA0131 RAIL ROAD MEDICARE
Illinois MEDICAID 036084895 RAIL ROAD MEDICARE

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