NPI | 1649313842 |
---|---|
Doing Business As | PASSPORT HEALTH |
Entity Type | Organization |
Authorized Contact | SCOTT M MORCOTT Medical Director 847-816-3434 |
Organization Subpart ? | No |
Primary Taxonomy | 261Q00000X Clinic/Center (Licence: IL 036-099609) |
Enumeration Date | 2007-02-15 |
Last Update Date | 2020-08-22 |