| NPI | 1508995762 |
|---|---|
| Doing Business As | PRAIRIE MEDICAL GROUP |
| Entity Type | Organization |
| Authorized Contact | THOMAS M NELSON Managing Partner 708-562-5430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Enumeration Date | 2007-03-05 |
| Last Update Date | 2013-05-15 |