| Nocd Illinois Pc | |
|
6160 N Cicero Ave Chicago IL 60646 | |
| (312) 569-0820 | |
| Not Available |
| Full Name | Nocd Illinois Pc |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 6160 N Cicero Ave, Chicago, Illinois |
| Authorized Official Name and Position | Larry Trusky (COO) |
| Authorized Official Contact | 3125690820 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Nocd Illinois Pc 225 N Michigan Ave Ste 1430 Chicago IL 60601-7653 Ph: (312) 569-0820 | Nocd Illinois Pc 6160 N Cicero Ave Chicago IL 60646 Ph: (312) 569-0820 |
| NPI Number | 1164051108 |
|---|---|
| Provider Enumeration Date | 04/02/2020 |
| Last Update Date | 04/07/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164051108 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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