Evergreen Medical, Ltd.

NPI #1245237460 in Evergreen Park, Illinois

Provider Information

NPI Number: 1245237460
Entity Type: Organization
Organization Name: Evergreen Medical, Ltd.
Primary Specialty: Family Medicine
Enumeration Date: Jul 1, 2005
Last Updated: Mar 22, 2018

Practice Location

Address: 2850 W 95TH ST
Address 2: SUITE 403
City: Evergreen Park
State: Illinois
ZIP Code: 60805-2735
Phone: (708) 423-2662

Authorized Official

Name: JOHN R ELSEN, M.D.
Title: PRESIDENT
Phone: (708) 423-2662

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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