Specialty Physicians Of Illinois, Llc

NPI 1124075676 - Dermatology - 207N00000X

NPI Details
NPI 1124075676
Enumeration Date 05/30/2006
Last Updated 03/11/2015
Entity Type Healthcare Provider
Active Over 10 years ago
Authorized Information
Name BRAD BRAD
Position PBS DIRECTOR
Phone (708) 679-2013
Fax (708) 503-3295
Practice Location
3700 W 203RD ST
SUITE 200
OLYMPIA FIELDS IL, 60461-1180, US
Phone (708) 679-2013
Fax (708) 503-3295
Business Location
1040 SIERRA DR
SUITE 400
GREENWOOD IN, 46143-7240, US
Phone (317) 528-4253
Fax (317) 865-8319
Toxanomy
Taxonomy Code 207N00000X
License State
License Number
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According to our database, Specialty Physicians Of Illinois, Llc NPI is 1124075676, taxonomy code is 207N00000X Specialty Physicians Of Illinois, Llc physically located at 3700 W 203rd St, Olympia Fields IL, 60461-1180. NPI Number 1033115704 has the healthcare provider type.

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1124075676 NPI number is provided on an as is basis without warranty of any kind. 1124075676 is maintained by the National Plan & Provider Enumeration System. The contents of Specialty Physicians Of Illinois, Llc are for informational purposes only.