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MELROSE PARK CLINIC NPI 1578603023


NPI Information

NPI: 1578603023
Provider Name: MELROSE PARK CLINIC
Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 14D2170868

Address:
1252 WINSTON PLAZA
MELROSE PARK, IL
ZIP 60160
Phone: (708) 343-2500
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MELROSE PARK CLINIC is a family medicine in Melrose Park, IL. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MELROSE PARK CLINIC NPI is 1578603023. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

1252 WINSTON PLAZA
MELROSE PARK, IL
ZIP 60160
Phone: (708) 343-2500
Fax: (708) 343-9545

The provider's authorized official is Joseph L Gaccluno .
The authorized official title is Administrator Owner and has the following contact phone number (708) 343-2500.

The CLIA number assigned to this NPI record is 14D2170868 - end stage renal disease dialysis facility with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 2/7/2007 and was last updated on 8/22/2020.


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:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207Q00000XFamily MedicineYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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