Nutrimedicos

NPI 1376886820 - Family Medicine - 207QB0002X

NPI Details
NPI 1376886820
Enumeration Date 04/03/2013
Last Updated 04/03/2013
Entity Type Healthcare Provider
Active Over 5 years ago
Authorized Information
Name LARRY LARRY
Position BILLING MANAGER
Phone (312) 929-2927
Fax
Practice Location
1719 W 18TH ST
CHICAGO IL, 60608-4833, US
Phone (312) 929-2927
Fax
Business Location
1719 W 18TH ST
CHICAGO IL, 60608-4833, US
Phone (312) 929-2927
Fax
Toxanomy
Taxonomy Code 207QB0002X
License State Illinois
License Number 036117092
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According to our database, Nutrimedicos NPI is 1376886820, taxonomy code is 207QB0002X and license number is 036117092, license state is located at Illinois. Nutrimedicos physically located at 1719 W 18th St, Chicago IL, 60608-4833. NPI Number 1033115704 has the healthcare provider type.

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1376886820 NPI number is provided on an as is basis without warranty of any kind. 1376886820 is maintained by the National Plan & Provider Enumeration System. The contents of Nutrimedicos are for informational purposes only.