Family Medical Center of Lagrange Ltd

NPI #1649355793 in Lagrange, Illinois

Provider Information

NPI Number: 1649355793
Entity Type: Organization
Organization Name: Family Medical Center of Lagrange Ltd
Primary Specialty: Family Medicine
Enumeration Date: Oct 26, 2006
Last Updated: Nov 5, 2012

Practice Location

Address: 5201 S WILLOW SPRINGS ROAD
Address 2: SUITE 300
City: Lagrange
State: Illinois
ZIP Code: 60525
Phone: (708) 482-8088

Authorized Official

Name: MR. MICHAEL FRANCIS DUPONT, MD
Title: VICE PRESIDENT PHYSICIAN
Phone: (708) 482-8088

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Family Medicine	207Q00000X	Primary

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