Infinitus Corporation | |
333 N Randall Rd Suite 140 St Charles IL 60174-1500 | |
(800) 356-3627 | |
Not Available |
Full Name | Infinitus Corporation |
---|---|
Speciality | Internal Medicine |
Location | 333 N Randall Rd, St Charles, Illinois |
Authorized Official Name and Position | Moqueet Syed (CREDENTIALING MANAGER) |
Authorized Official Contact | 6304407786 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Infinitus Corporation 333 N Randall Rd Suite 140 St Charles IL 60174-1500 Ph: () - | Infinitus Corporation 333 N Randall Rd Suite 140 St Charles IL 60174-1500 Ph: (800) 356-3627 |
NPI Number | 1588044507 |
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Provider Enumeration Date | 06/04/2015 |
Last Update Date | 06/04/2015 |
Identifier | Type | State | Issuer |
---|---|---|---|
1588044507 | NPI | - | NPPES |
336069152 | Other | IL | CONTROLLED SUBSTANCE LICENSE |
036108385 | Other | IL | LICENSE NUMBER |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207R00000X | Internal Medicine | 036108385 (Illinois) | Primary |
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