Main Street Medical Group Llc

LBN: Main Street Medical Group Llc
Main Street Medical Group Llc is an health care organization with primary practice located at 124 Regency Park Ste 7 , O Fallon IL 62269-1994. The organization recently has 6 registered licenses in different health care specialties including Chiropractic Providers / Chiropractor, Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / General Practice, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, Physician Assistants & Advanced Practice Nursing Providers / Family. Allopathic & Osteopathic Physicians / General Practice is the primary health care specialty. Main Street Medical Group Llc can be contacted via phone (480) 926-2260, or through Descalzo, Ellie via phone (480) 926-7800.

Contact Information

Primary practice address
124 Regency Park Ste 7 O Fallon IL 62269-1994
Phone: (480) 926-2260
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Descalzo, Ellie
Phone: (480) 926-7800

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X
Allopathic & Osteopathic Physicians / General Practice 208D00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X

Profile Details

NPI number 1043832769
LBN Legal business name Main Street Medical Group Llc
DBA Doing business as
Authorized official Descalzo, Ellie
Entity Organization
Organization subpart 1 No
Enumeration date May 15th, 2020
Last updated May 4th, 2021 - about 4 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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