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401 E Congress Pkwy Crystal Lake IL 60014-6210 | |
| (779) 220-9300 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Community Health |
| Location | 401 E Congress Pkwy, Crystal Lake, Illinois |
| Authorized Official Name and Position | Suzanne Hoban (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 7792209315 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
401 E Congress Pkwy Crystal Lake IL 60014-6210 Ph: (779) 220-9300 | 401 E Congress Pkwy Crystal Lake IL 60014-6210 Ph: (779) 220-9300 |
| NPI Number | 1215398573 |
|---|---|
| Provider Enumeration Date | 03/15/2016 |
| Last Update Date | 03/24/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215398573 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QC1500X | Clinic/center - Community Health | (* (Not Available)) | Primary |
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