MACENTEE KNOX & VARGAS MDS

CHICAGO, IL
NPI1275729303
Doing Business AsSOUTHCARE FAMILY PRACTICE
Entity TypeOrganization
Authorized ContactPETER F MACENTEE
President
773-779-9300
Organization Subpart ?No
Primary Taxonomy305R00000X Preferred Provider Organization
(Licence: IL  036072512)
Additional Taxonomies305R00000X Preferred Provider Organization
(Licence: IL  036047977)
305S00000X Point of Service
(Licence: IL  036063080)
Enumeration Date2007-09-21
Last Update Date2011-03-08
Business Address
MACENTEE KNOX & VARGAS MDS
10627 S PULASKI RD
CHICAGO, IL 60655-3827
Phone number: 773-779-9300
Mailing Address
MACENTEE KNOX & VARGAS MDS
10627 S PULASKI RD
CHICAGO, IL 60655-3827
Phone number: 773-779-9300