Regency Park Medical Group LLC

NPI #1063034783 in O Fallon, Illinois

Provider Information

NPI Number: 1063034783
Entity Type: Organization
Organization Name: Regency Park Medical Group LLC
Primary Specialty: General Practice
Enumeration Date: May 15, 2020
Last Updated: Aug 19, 2021

Practice Location

Address: 124 REGENCY PARK STE 7
City: O Fallon
State: Illinois
ZIP Code: 62269-1994
Phone: (480) 926-7800

Authorized Official

Name: ELLIE DESCALZO
Title: CREDENTIALING OFFICER
Phone: (480) 926-7800

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Chiropractor	111N00000X
Internal Medicine	207R00000X
Physical Therapist	225100000X
Physician Assistant	363A00000X
Nurse Practitioner - Family — Family	363LF0000X
General Practice	208D00000X	Primary

Similar Providers

Individual Providers

Provider Name	Specialty	City
Paul Kasunic, DO	General Practice	O Fallon	AI Deep Dive
MR. Robert F Ladove, MD	General Practice	O Fallon	AI Deep Dive
Reese Jerel Cooper, DO	General Practice	O Fallon	AI Deep Dive
Santosh Raja, DO	General Practice	O Fallon	AI Deep Dive

Organizations

Provider Name	Specialty	City
Main Street Medical Group LLC	General Practice	O Fallon	AI Deep Dive

Want to research this healthcare provider further?

Try NewBizBot free