Provider Demographics
NPI:1194885970
Name:MIDWEST HEALTHPLUS LTD
Entity type:Organization
Organization Name:MIDWEST HEALTHPLUS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SEDO
Authorized Official - Middle Name:
Authorized Official - Last Name:TAMAKLOE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:312-791-2181
Mailing Address - Street 1:7348 WINTHROP WAY
Mailing Address - Street 2:UNIT 5
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60516-4080
Mailing Address - Country:US
Mailing Address - Phone:312-917-2181
Mailing Address - Fax:312-791-2508
Practice Address - Street 1:2929 S EILLS AVE
Practice Address - Street 2:4 KAPLAN
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60616
Practice Address - Country:US
Practice Address - Phone:312-791-2181
Practice Address - Fax:312-791-2508
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty