Villasenor In-home Patient Care Llc

NPI 1780006619 - Family Medicine - 207Q00000X

NPI Details
NPI 1780006619
Enumeration Date 01/12/2014
Last Updated 01/12/2014
Entity Type Healthcare Provider
Active Over 2 years ago
Authorized Information
Name JERRY JERRY
Position FAMILY PRACTICE
Phone (708) 788-2801
Fax (847) 787-5252
Practice Location
1639 OAK PARK AVE
BERWYN IL, 60402-1782, US
Phone (708) 788-2801
Fax (847) 787-5252
Business Location
1639 OAK PARK AVE
BERWYN IL, 60402-1782, US
Phone (708) 788-2801
Fax (847) 787-5252
Toxanomy
Taxonomy Code 207Q00000X
License State Illinois
License Number 036-111596
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According to our database, Villasenor In-home Patient Care Llc NPI is 1780006619, taxonomy code is 207Q00000X and license number is 036-111596, license state is located at Illinois. Villasenor In-home Patient Care Llc physically located at 1639 Oak Park Ave, Berwyn IL, 60402-1782. NPI Number 1033115704 has the healthcare provider type.

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1780006619 NPI number is provided on an as is basis without warranty of any kind. 1780006619 is maintained by the National Plan & Provider Enumeration System. The contents of Villasenor In-home Patient Care Llc are for informational purposes only.