Heritage Medical Group Ltd

LBN: Heritage Medical Group Ltd
Heritage Medical Group Ltd is an health care organization with primary practice located at 5660 W 95Th St Suite 6, Oak Lawn IL 60453-2380. The organization recently has only one registered license in Other Service Providers / Specialist, which is considered as the primary health care specialty. Heritage Medical Group Ltd can be contacted via phone (708) 499-3676, or through Stavrakos, Maria N via phone (708) 499-3676.

Contact Information

Primary practice address
5660 W 95Th St Suite 6 Oak Lawn IL 60453-2380
Phone: (708) 499-3676
Fax: (708) 499-1792
Website:
Map and Directions
Authorized official contact:
Name: Stavrakos, Maria N
Phone: (708) 499-3676

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1033121421
LBN Legal business name Heritage Medical Group Ltd
DBA Doing business as
Authorized official Stavrakos, Maria N
Entity Organization
Organization subpart 1 No
Enumeration date Aug 13th, 2006
Last updated Dec 6th, 2007 - about 17 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 1033121421 NPPES
Illinois Other 1617593 BLUECROSSBLUESHIELD
Illinois Other CM1337 BLUECROSSBLUESHIELD

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