Basic Information
| Provider Information | |||||||||
| NPI: | 1811011901 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | QV INC | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | UNIVERSITY OF CHICAGO PHYSICIANS GROUP-QV INC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 180 HARVESTER DR | ||||||||
| Address2: | SUITE 110 | ||||||||
| City: | BURR RIDGE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605275993 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662090027 | ||||||||
| FaxNumber: | 7737020000 | ||||||||
| Practice Location | |||||||||
| Address1: | 7955 S CASS AVE | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | DARIEN | ||||||||
| State: | IL | ||||||||
| PostalCode: | 605615132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8662090027 | ||||||||
| FaxNumber: | 7738378260 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/16/2007 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | FINESILVER | ||||||||
| AuthorizedOfficialFirstName: | JEFFREY | ||||||||
| AuthorizedOfficialMiddleName: | A | ||||||||
| AuthorizedOfficialTitleorPosition: | PRESIDENT, QV INC | ||||||||
| AuthorizedOfficialTelephone: | 7737029797 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MR. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QM1300X | Y | Ambulatory Health Care Facilities | Clinic/Center | Multi-Specialty |
No ID Information.