| Bun Siu L Co, Md, Sc | |
|
300 Read St Suite C Lockport IL 60441-3265 | |
| (815) 838-7965 | |
| (815) 838-8011 |
| Full Name | Bun Siu L Co, Md, Sc |
|---|---|
| Speciality | Internal Medicine |
| Location | 300 Read St, Lockport, Illinois |
| Authorized Official Name and Position | Daniel R Co (PRESIDENT/OWNER) |
| Authorized Official Contact | 8158387965 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bun Siu L Co, Md, Sc 300 Read St Suite C Lockport IL 60441-3265 Ph: (815) 838-7965 | Bun Siu L Co, Md, Sc 300 Read St Suite C Lockport IL 60441-3265 Ph: (815) 838-7965 |
| NPI Number | 1417149972 |
|---|---|
| Provider Enumeration Date | 08/17/2007 |
| Last Update Date | 08/17/2007 |
| Medicare PECOS PAC ID | 3870686520 |
|---|---|
| Medicare Enrollment ID | O20070911000591 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1417149972 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Illinois) | Primary |
| Provider Name | Daniel R Co |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1609858547 PECOS PAC ID: 6608969357 Enrollment ID: I20070911000586 |
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