Provider

NEPTUNE

Public NPPES listing with taxonomy: Internal Medicine.

Resource details

Medicare status: Confirm directly

Unknown from NPPES

Source: NPPES NPI Registry

NPI: 1720447667

Taxonomy: Internal Medicine (207R00000X)

Source confidence: 58%

Medicare assignment: Unknown from NPPES

Address: 2189 N IL ROUTE 83 STE 220, ROUND LAKE BEACH, IL, 600734906

Phone: 312-857-5382

Last verified: May 18, 2026