Main Street Medical Group Llc in O Fallon, IL - General Practice

Main Street Medical Group Llc is a General Practice based in O Fallon, Illinois. Main Street Medical Group Llc is licensed to practice in * (Not Available) (license number ) and their current practice location is 124 Regency Park Ste 7, O Fallon, Illinois. It can be reached at their office (for appointments etc.) via phone at (480) 926-2260.

NPI number for Main Street Medical Group Llc is 1043832769 and their current mailing address is 2250 E Germann Rd Ste 8, Chandler, Arizona. Main Street Medical Group Llc does not participate in medicare program and thus does not accept medicare assignments. The facility's NPI Number is 1043832769.

Contact Information

	Main Street Medical Group Llc
	124 Regency Park Ste 7, O Fallon, IL 62269-1994
	(480) 926-2260
	Not Available

Healthcare Provider's Profile

Full Name	Main Street Medical Group Llc
Type	Facility
Speciality	General Practice
Location	124 Regency Park Ste 7, O Fallon, Illinois
Accepts Medicare Assignments	Does not participate in Medicare Program. The facility may not accept medicare assignment.

NPI Data:

NPI Number: 1043832769
Provider Enumeration Date: 05/15/2020
Last Update Date: 05/04/2021

Medical Identifiers

Medical identifiers for Main Street Medical Group Llc such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1043832769	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
111N00000X	Chiropractor	(* (Not Available))	Secondary
207R00000X	Internal Medicine	(* (Not Available))	Secondary
208D00000X	General Practice	(* (Not Available))	Primary
225100000X	Physical Therapist	(* (Not Available))	Secondary
363A00000X	Physician Assistant	(* (Not Available))	Secondary
363LF0000X	Nurse Practitioner - Family	(* (Not Available))	Secondary

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Main Street Medical Group Llc is NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
Main Street Medical Group Llc 2250 E Germann Rd Ste 8, Chandler, AZ 85286-1575 Ph: (480) 926-7800	Main Street Medical Group Llc 124 Regency Park Ste 7, O Fallon, IL 62269-1994 Ph: (480) 926-2260

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Main Street Medical Group Llc - in O Fallon, IL