Basic Information
Provider Information
NPI: 1982828422
EntityType: 2
ReplacementNPI:  
OrganizationName: MIDWEST ACUTE CARE CONSULTANTS PC
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Mailing Information
Address1: 11155 DUNN RD STE 315E
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631366111
CountryCode: US
TelephoneNumber: 3143557500
FaxNumber: 3143553287
Practice Location
Address1: 1 PROFESSIONAL DR STE 150
Address2:  
City: ALTON
State: IL
PostalCode: 620025068
CountryCode: US
TelephoneNumber: 6184668660
FaxNumber: 6184638666
Other Information
ProviderEnumerationDate: 04/13/2007
LastUpdateDate: 08/22/2020
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AuthorizedOfficialLastName: LEVY
AuthorizedOfficialFirstName: NAT
AuthorizedOfficialMiddleName: T
AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 3143557500
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IsOrganizationSubpart: N
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AuthorizedOfficialCredential: MD
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Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RI0200X ILY193200000X MULTI-SPECIALTY GROUPAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease

No ID Information.


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