Olympia Fields Internal Medicine

NPI #1336170844 in Flossmoor, Illinois

Provider Information

NPI Number: 1336170844
Entity Type: Organization
Organization Name: Olympia Fields Internal Medicine
Primary Specialty: Family Medicine
Enumeration Date: Jul 5, 2006
Last Updated: Apr 29, 2009

Practice Location

Address: 19550 S GOVERNORS HIGHWAY
Address 2: STE 2000
City: Flossmoor
State: Illinois
ZIP Code: 60422-2136
Phone: (708) 957-8750

Authorized Official

Name: MS. LOIS A GLASGOW
Title: AGENT OF RECORD PRESIDENT
Phone: (708) 957-8750

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Internal Medicine - Endocrinology, Diabetes & Metabolism — Endocrinology, Diabetes & Metabolism	207RE0101X
Internal Medicine - Nephrology — Nephrology	207RN0300X
Family Medicine	207Q00000X	Primary

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