LCR PRIMARY CARE LLC

EVERGREEN PARK, IL
NPI1588037873
Entity TypeOrganization
Authorized ContactLORETTA B. JOHNSON
Owner
773-431-1508
Organization Subpart ?No
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: IL  302F00000x)
Enumeration Date2015-11-09
Last Update Date2015-11-09
Business Address
LCR PRIMARY CARE LLC
9237 S.PULASKI STE. 2S
EVERGREEN PARK, IL 60805
Phone number: 773-431-1508
Mailing Address
LCR PRIMARY CARE LLC
9237 S PULASKI RD STE 2S
EVERGREEN PARK, IL 60805-1454
Phone number: 773-431-1508