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701 Winthrop Ave Glendale Heights IL 60139-1405 | |
| (708) 245-4073 | |
| (708) 245-5614 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Geriatric Medicine |
| Location | 701 Winthrop Ave, Glendale Heights, Illinois |
| Authorized Official Name and Position | Ruby Mann (DIRECTOR OF MANAGED CARE) |
| Authorized Official Contact | 63085668844 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 7009 Bolingbrook IL 60440-7009 Ph: (630) 312-7865 | 701 Winthrop Ave Glendale Heights IL 60139-1405 Ph: (708) 245-4073 |
| NPI Number | 1679518765 |
|---|---|
| Provider Enumeration Date | 06/20/2006 |
| Last Update Date | 01/08/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679518765 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
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