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1447784921
1915-25 95TH ST., LLC
CHICAGO, IL
NPI
1447784921
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Entity Type
Organization
Authorized Contact
RAVISH SHAH
Office Manager
630-571-1100
Organization Subpart ?
No
Primary Taxonomy
261QA1903X Clinic/Center, Ambulatory Surgical
Enumeration Date
2017-04-12
Last Update Date
2017-04-12
Business Address
1915-25 95TH ST., LLC
1915 E 95TH ST
CHICAGO, IL 60617
Phone number: 630-571-1100
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Mailing Address
1915-25 95TH ST., LLC
1915 E 95TH STREET
CHICAGO, IL 60617
Phone number: 630-571-1100
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