Basic Information
| Provider Information | |||||||||
| NPI: | 1518181015 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | PARKVIEW FAMILY PRACTICE, P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 109 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | STREATOR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 613642223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156724587 | ||||||||
| FaxNumber: | 8156733582 | ||||||||
| Practice Location | |||||||||
| Address1: | 109 E ELM ST | ||||||||
| Address2: | |||||||||
| City: | STREATOR | ||||||||
| State: | IL | ||||||||
| PostalCode: | 613642223 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8156724587 | ||||||||
| FaxNumber: | 8156733582 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/13/2007 | ||||||||
| LastUpdateDate: | 04/20/2010 | ||||||||
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| AuthorizedOfficialLastName: | RIBLET | ||||||||
| AuthorizedOfficialFirstName: | ELIZABETH | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER | ||||||||
| AuthorizedOfficialTelephone: | 8156724587 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 036060768 | IL | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Family Medicine |
No ID Information.