| Organization Name: | MIDWEST PHYSICIAN GROUP LTD |
| NPI Number: | 1053599167 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | DEBORAH J NELSON (CEO) |
| Mailing Address: | 20110 Governors Hwy 1st Floor Olympia Fields |
| State: | IL US |
| Postal Code: | 604611030 |
| Phone Number: | 7087477960 |
| Fax Number: | 7085033993 |
| NPI Enumeration Date: | 01/31/2008 |
| NPI Last Update Date: | 01/31/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QP2000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Physical Therapy |
| Taxonomy Definition: | |