Tj Corporation I Llc

NPI 1063417046 - Clinic/Center - 261QP2000X

NPI Details
NPI 1063417046
Enumeration Date 06/16/2005
Last Updated 05/07/2013
Entity Type Healthcare Provider
Active Over 11 years ago
Authorized Information
Name MICHAEL E. MICHAEL
Position VICE PRESIDENT
Phone (773) 252-4921
Fax (773) 252-5067
Practice Location
2569 W FULLERTON AVE
CHICAGO IL, 60647-3147, US
Phone (773) 252-4921
Fax (773) 252-5067
Business Location
4714 GETTYSBURG RD
LEGAL DEPARTMENT
MECHANICSBURG PA, 17055-4325, US
Phone (717) 972-1100
Fax (717) 975-9981
Toxanomy
Taxonomy Code 261QP2000X
License State
License Number
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According to our database, Tj Corporation I Llc NPI is 1063417046, taxonomy code is 261QP2000X Tj Corporation I Llc physically located at 2569 W Fullerton Ave, Chicago IL, 60647-3147. NPI Number 1033115704 has the healthcare provider type.

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1063417046 NPI number is provided on an as is basis without warranty of any kind. 1063417046 is maintained by the National Plan & Provider Enumeration System. The contents of Tj Corporation I Llc are for informational purposes only.