ELLEN M HENNECKE DOSC

EVERGREEN PARK, IL
NPI1780885657
Entity TypeOrganization
Authorized ContactKIM WYLIE
Office Manager
708-799-8440
Organization Subpart ?No
Primary Taxonomy207Q00000X Family Medicine
(Licence: IL  036083750)
Enumeration Date2007-05-30
Last Update Date2020-08-22
Business Address
ELLEN M HENNECKE DOSC
3927 W 95TH ST
EVERGREEN PARK, IL 60805-1903
Phone number: 708-799-8440
Mailing Address
ELLEN M HENNECKE DOSC
18141 DIXIE HWY STE 107
HOMEWOOD, IL 60430-2241
Phone number:
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