Blue Island Clinic Company LLC

NPI #1609148139 in Blue Island, Illinois

Provider Information

NPI Number: 1609148139
Entity Type: Organization
Organization Name: Blue Island Clinic Company LLC
Primary Specialty: Internal Medicine
Enumeration Date: Jan 30, 2012
Last Updated: Jan 30, 2012

Practice Location

Address: 12935 GREGORY ST
City: Blue Island
State: Illinois
ZIP Code: 60406-2428
Phone: (708) 597-2000

Authorized Official

Name: DEBBIE T BREWER
Title: DIRECTOR
Phone: (615) 465-7626

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X
Obstetrics & Gynecology	207V00000X
Physician Assistant	363A00000X
Advanced Practice Midwife	367A00000X
Internal Medicine	207R00000X	Primary

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