Crystal Lake Center For Chronic Pain Sc

NPI 1154729838 - Nurse Practitioner - 363L00000X

NPI Details
NPI 1154729838
Enumeration Date 12/12/2014
Last Updated 12/12/2014
Entity Type Healthcare Provider
Active Over 1 year ago
Authorized Information
Name GREG GREG
Position OWNER
Phone (815) 356-9371
Fax
Practice Location
1 SOUTH NORTHWEST HIGHWAY
CRYSTAL LAKE IL, 60014, US
Phone (815) 356-9371
Fax
Business Location
1 SOUTH NORTHWEST HIGHWAY
CRYSTAL LAKE IL, 60014, US
Phone (815) 356-9371
Fax
Toxanomy
Taxonomy Code 363L00000X
License State
License Number
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According to our database, Crystal Lake Center For Chronic Pain Sc NPI is 1154729838, taxonomy code is 363L00000X Crystal Lake Center For Chronic Pain Sc physically located at 1 South Northwest Highway, Crystal Lake IL, 60014. NPI Number 1033115704 has the healthcare provider type.

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1154729838 NPI number is provided on an as is basis without warranty of any kind. 1154729838 is maintained by the National Plan & Provider Enumeration System. The contents of Crystal Lake Center For Chronic Pain Sc are for informational purposes only.