John R Deforest D.o. S.c.

NPI #1144241407 in Beecher, Illinois

Provider Information

NPI Number: 1144241407
Entity Type: Organization
Organization Name: John R Deforest D.o. S.c.
Primary Specialty: Family Medicine
Enumeration Date: Jul 22, 2006
Last Updated: Dec 10, 2014

Practice Location

Address: 715 S DIXIE HWY
City: Beecher
State: Illinois
ZIP Code: 60401-3668
Phone: (708) 946-9330

Authorized Official

Name: KAREN RUCKMAN
Title: ACCT REP.
Phone: (708) 946-3990

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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