OrganizationMoraine Emergency PhysiciansEmergency MedicineAllopathic & Osteopathic PhysiciansPractice Address4102 Medical Center Drive, Mchenry, IL 60050(815) 344-5000(800) 732-1066PECOS EnrollmentBased on the most recent information from CMS, provider Moraine Emergency Physicians does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1457395667Provider TypeOrganizationFull NameMoraine Emergency PhysiciansSubpartNoEnumeration Date6/16/2006Last Updated4/20/2008Contact InformationPractice LocationPractice Address4102 Medical Center Drive, Mchenry, IL 60050Phone(815) 344-5000Fax(815) 759-4293Mailing LocationMailing AddressPO Box 8759, Philadelphia, PA 19101-8759Phone(800) 732-1066Fax(630) 941-4333Authorized OfficialNameWebster, Douglas P (Owner/General Partner)Phone(800) 732-1066Provider TaxonomiesCodeDescriptionLicenseCode207P00000XPrimaryDescriptionEmergency MedicineAllopathic & Osteopathic PhysiciansLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID05623906DescriptionOtherIssuerBLUE SHIELDIllinois