Grace Medical Center, Sc

NPI 1457405300 - Exclusive Provider Organization - 302F00000X

NPI Details
NPI 1457405300
Enumeration Date 01/22/2007
Last Updated 11/17/2011
Entity Type Healthcare Provider
Active Over 9 years ago
Authorized Information
Name CHUNG S CHUNG
Position PROVIDER
Phone (847) 854-5533
Fax
Practice Location
2250 W ALGONQUIN RD
SUITE 112
LAKE IN THE HILLS IL, 60156-1289, US
Phone (847) 854-5533
Fax
Business Location
2250 W ALGONQUIN RD
SUITE 112
LAKE IN THE HILLS IL, 60156-1289, US
Phone (847) 854-5533
Fax
Toxanomy
Taxonomy Code 302F00000X
License State Illinois
License Number 036083588
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According to our database, Grace Medical Center, Sc NPI is 1457405300, taxonomy code is 302F00000X and license number is 036083588, license state is located at Illinois. Grace Medical Center, Sc physically located at 2250 W Algonquin Rd, Lake In The Hills IL, 60156-1289. NPI Number 1033115704 has the healthcare provider type.

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1457405300 NPI number is provided on an as is basis without warranty of any kind. 1457405300 is maintained by the National Plan & Provider Enumeration System. The contents of Grace Medical Center, Sc are for informational purposes only.