Logan Multispecialty Clinic S C

LBN: Logan Multispecialty Clinic S C
Logan Multispecialty Clinic S C is an health care organization with primary practice located at 15W560 91St St , Burr Ridge IL 60527-6365. The organization recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as the primary health care specialty. Logan Multispecialty Clinic S C can be contacted via phone (630) 532-2021, or through Dovale, Facundo Benito via phone (630) 532-2021.

Contact Information

Primary practice address
15W560 91St St Burr Ridge IL 60527-6365
Phone: (630) 532-2021
Fax: (630) 655-1815
Website:
Map and Directions
Authorized official contact:
Name: Dovale, Facundo Benito Doctor of Medicine (MD)
Phone: (630) 532-2021

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 036085934 Illinois

Profile Details

NPI number 1770015836
LBN Legal business name Logan Multispecialty Clinic S C
DBA Doing business as
Authorized official Dovale, Facundo Benito Doctor of Medicine (MD)
Entity Organization
Organization subpart 1 No
Enumeration date Mar 29th, 2017
Last updated Mar 21st, 2018 - about 8 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1770015836 NPPES
Illinois MEDICAID 20150720620350

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