EVERGREEN AESTHETIC INSTITUTE LLC

EFFINGHAM, IL
NPI1710073176
Doing Business AsEAI
Entity TypeOrganization
Authorized ContactTHEODORE FIFER
Medical Director
217-342-7090
Organization Subpart ?No
Primary Taxonomy261QA0006X Clinic/Center, Ambulatory Fertility Facility
(Licence: IL  2198)
Enumeration Date2006-10-05
Last Update Date2020-08-22
Business Address
EVERGREEN AESTHETIC INSTITUTE LLC
1104 W EVERGREEN AVE SUITE B
EFFINGHAM, IL 62401-1710
Phone number: 217-342-7090
Mailing Address
EVERGREEN AESTHETIC INSTITUTE LLC
1104 W EVERGREEN AVE SUITE B
EFFINGHAM, IL 62401-1710
Phone number: 217-342-7090