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General NPI Number Information
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NPI Number | 1053718445
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Entity Type | Organization
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Legal Business Name | COMPANIAN ANIMAL SPECIALTY AND EMERGENCY HOSPITAL
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Dates
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Enumeration Date | 12/01/2014
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Last Update Date | 12/01/2014
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Provider Practice Location Address
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Address Line | 1095 PINGREE RD SUITE 120
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-1725
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Country | US
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Telephone | 815-479-9119
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Fax | 847-854-9119
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Provider Business Mailing Address
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Address Line | 1095 PINGREE RD SUITE 120
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City | CRYSTAL LAKE
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State | IL
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Zip | 60014-1725
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Country | US
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Telephone | 815-479-9119
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Fax | 847-854-9119
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Authorized Official
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Title or Position | VETERINARIAN
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Name | DR. ALICIA MARIE RAGNI
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Credential | D.V.M.
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Telephone | 815-479-9119
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174M00000X
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Taxonomy Name | Veterinarian
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License Number | 090-006289
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License Number State | IL
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