Horsefeathers

NPI 1063811149 - Clinic/Center - 261QD1600X

NPI Details
NPI 1063811149
Enumeration Date 08/14/2014
Last Updated 08/14/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name NICHOLAS EB NICHOLAS
Position PRESIDENT
Phone (847) 234-2411
Fax (847) 905-0737
Practice Location
1181 RIVERWOODS RD
LAKE FOREST IL, 60045-3459, US
Phone (847) 234-2411
Fax (847) 905-0737
Business Location
1181 RIVERWOODS RD
LAKE FOREST IL, 60045-3459, US
Phone (847) 234-2411
Fax (847) 905-0737
Toxanomy
Taxonomy Code 261QD1600X
License State Illinois
License Number 056.006145
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According to our database, Horsefeathers NPI is 1063811149, taxonomy code is 261QD1600X and license number is 056.006145, license state is located at Illinois. Horsefeathers physically located at 1181 Riverwoods Rd, Lake Forest IL, 60045-3459. NPI Number 1033115704 has the healthcare provider type.

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1063811149 NPI number is provided on an as is basis without warranty of any kind. 1063811149 is maintained by the National Plan & Provider Enumeration System. The contents of Horsefeathers are for informational purposes only.