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General NPI Number Information
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NPI Number | 1093904096
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Entity Type | Organization
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Legal Business Name | ILLINOIS ARTHRITIS CENTER, SC
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Dates
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Enumeration Date | 10/16/2007
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Last Update Date | 04/02/2008
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Provider Practice Location Address
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Address Line | 15300 WEST AVE STE. 201
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City | ORLAND PARK
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State | IL
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Zip | 60462-4600
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Country | US
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Telephone | 708-403-7788
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Fax |
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Provider Business Mailing Address
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Address Line | 15300 WEST AVE STE. 201
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City | ORLAND PARK
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State | IL
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Zip | 60462-4600
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Country | US
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Telephone | 708-403-7788
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | CORY L. CONNIFF
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Credential | MD
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Telephone | 708-403-7788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number |
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License Number State |
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