Provider Demographics
NPI:1770989584
Name:ALEXIAN BROTHERS MEDICAL CARE GROUP NFP
Entity type:Organization
Organization Name:ALEXIAN BROTHERS MEDICAL CARE GROUP NFP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHEIF EXECUTIVE OFFICER
Authorized Official - Prefix:MS
Authorized Official - First Name:BETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:TZE
Authorized Official - Suffix:
Authorized Official - Credentials:CEO
Authorized Official - Phone:847-385-7321
Mailing Address - Street 1:3040 W SALT CREEK LN
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60005-1069
Mailing Address - Country:US
Mailing Address - Phone:847-870-4780
Mailing Address - Fax:847-483-7447
Practice Address - Street 1:3040 W SALT CREEK LN
Practice Address - Street 2:
Practice Address - City:ARLINGTON HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60005-1069
Practice Address - Country:US
Practice Address - Phone:847-870-4780
Practice Address - Fax:847-483-7447
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-11-06
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty