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9711 Skokie Blvd Suite A Skokie IL 60077-1384 | |
| (847) 568-9930 | |
| (847) 568-9932 |
| Full Name | |
|---|---|
| Speciality | General Practice |
| Location | 9711 Skokie Blvd, Skokie, Illinois |
| Authorized Official Name and Position | Daniel Mccormick (SENIOR VICE PRESIDENT) |
| Authorized Official Contact | 7085836817 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
62311 Collection Center Dr Chicago IL 60693-0623 Ph: (800) 273-2614 | 9711 Skokie Blvd Suite A Skokie IL 60077-1384 Ph: (847) 568-9930 |
| NPI Number | 1255603049 |
|---|---|
| Provider Enumeration Date | 02/08/2012 |
| Last Update Date | 02/08/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255603049 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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