Impact Physician Group, Illinois LLC

NPI #1467920124 in Plano, Illinois

Provider Information

NPI Number: 1467920124
Entity Type: Organization
Organization Name: Impact Physician Group, Illinois LLC
Primary Specialty: Internal Medicine
Enumeration Date: Nov 10, 2018
Last Updated: Dec 19, 2022

Practice Location

Address: 115 E SOUTH ST STE F
City: Plano
State: Illinois
ZIP Code: 60545-1595
Phone: (630) 552-7166

Authorized Official

Name: MR. PAUL MILLER
Title: CEO
Phone: (678) 967-5599

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine - Endocrinology, Diabetes & Metabolism — Endocrinology, Diabetes & Metabolism	207RE0101X
Internal Medicine - Gastroenterology — Gastroenterology	207RG0100X
Internal Medicine - Pulmonary Disease — Pulmonary Disease	207RP1001X
Internal Medicine	207R00000X	Primary

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