Gottlieb/ West Towns Pho, Inc.

NPI 1447359856 - Health Maintenance Organization - 302R00000X

NPI Details
NPI 1447359856
Enumeration Date 09/22/2006
Last Updated 06/07/2010
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name ERICA ERICA
Position CONTROLLER
Phone (708) 450-4945
Fax (708) 450-1150
Practice Location
675 W NORTH AVE
LOWER LEVEL
MELROSE PARK IL, 60160-1634, US
Phone (708) 450-4945
Fax (708) 450-1150
Business Location
675 W NORTH AVE
LOWER LEVEL
MELROSE PARK IL, 60160-1634, US
Phone (708) 450-4945
Fax (708) 450-1150
Toxanomy
Taxonomy Code 302R00000X
License State
License Number
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According to our database, Gottlieb/ West Towns Pho, Inc. NPI is 1447359856, taxonomy code is 302R00000X Gottlieb/ West Towns Pho, Inc. physically located at 675 W North Ave, Melrose Park IL, 60160-1634. NPI Number 1033115704 has the healthcare provider type.

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1447359856 NPI number is provided on an as is basis without warranty of any kind. 1447359856 is maintained by the National Plan & Provider Enumeration System. The contents of Gottlieb/ West Towns Pho, Inc. are for informational purposes only.