Basic Information
| Provider Information | |||||||||
| NPI: | 1699093674 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | HOSPITAL CARE CONSULTANTS OF SANDWICH LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 17304 PRESTON RD | ||||||||
| Address2: | SUITE 555 | ||||||||
| City: | DALLAS | ||||||||
| State: | TX | ||||||||
| PostalCode: | 752525618 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8669318882 | ||||||||
| FaxNumber: | 8665749651 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 E PLEASANT AVE | ||||||||
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| City: | SANDWICH | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605481100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8157868484 | ||||||||
| FaxNumber: | 8157863705 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/14/2010 | ||||||||
| LastUpdateDate: | 05/14/2010 | ||||||||
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| AuthorizedOfficialLastName: | WEISS | ||||||||
| AuthorizedOfficialFirstName: | RON | ||||||||
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| AuthorizedOfficialTitleorPosition: | CEO | ||||||||
| AuthorizedOfficialTelephone: | 9729343200 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208M00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Hospitalist | 207R00000X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.