| |
17w300 22nd St Suite 320 Oakbrook Terrace IL 60181-4405 | |
(630) 589-5010 | |
(630) 589-5011 |
Full Name | |
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Speciality | Family Medicine |
Location | 17w300 22nd St, Oakbrook Terrace, Illinois |
Authorized Official Name and Position | Merrill K Galera (MANAGER) |
Authorized Official Contact | 6305895010 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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17w300 22nd St Suite 320 Oakbrook Terrace IL 60181-4405 Ph: (630) 589-5010 | 17w300 22nd St Suite 320 Oakbrook Terrace IL 60181-4405 Ph: (630) 589-5010 |
NPI Number | 1164667580 |
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Provider Enumeration Date | 12/15/2008 |
Last Update Date | 06/10/2009 |
Identifier | Type | State | Issuer |
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1164667580 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | 036112459 (Illinois) | Primary |
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