Provider Demographics
NPI:1386091452
Name:ON CALL MEDICAL DOCTORS LLC
Entity type:Organization
Organization Name:ON CALL MEDICAL DOCTORS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ALI
Authorized Official - Middle Name:
Authorized Official - Last Name:MATARI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:708-224-6870
Mailing Address - Street 1:1851 DOUGLAS RD
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERY
Mailing Address - State:IL
Mailing Address - Zip Code:60538-2159
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1851 DOUGLAS RD
Practice Address - Street 2:
Practice Address - City:MONTGOMERY
Practice Address - State:IL
Practice Address - Zip Code:60538-2159
Practice Address - Country:US
Practice Address - Phone:708-224-6870
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-19
Last Update Date:2016-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty