Fountain Medical Group Sc

NPI #1992777171 in Sandwich, Illinois

Provider Information

NPI Number: 1992777171
Entity Type: Organization
Organization Name: Fountain Medical Group Sc
Primary Specialty: Surgery
Enumeration Date: Feb 2, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 15 W PLEASANT AVE
City: Sandwich
State: Illinois
ZIP Code: 60548-1050
Phone: (815) 786-2101

Authorized Official

Name: DR. EDWIN JOSEPH CAREY, MD
Title: PRESIDENT
Phone: (815) 786-2101

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Surgery	208600000X	Primary

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