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General NPI Number Information
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NPI Number | 1124578752
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Entity Type | Organization
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Legal Business Name | INSIGHT THERAPEUTICS, INC.
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Dates
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Enumeration Date | 10/06/2016
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Last Update Date | 10/06/2016
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Provider Practice Location Address
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Address Line | 27W140 ROOSEVELT RD SUITE 205
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City | WINFIELD
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State | IL
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Zip | 60190-1642
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Country | US
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Telephone | 847-800-9347
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Fax | 847-628-0791
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Provider Business Mailing Address
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Address Line | 27W140 ROOSEVELT RD SUITE 205
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City | WINFIELD
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State | IL
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Zip | 60190-1642
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Country | US
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Telephone | 847-800-9347
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Fax | 847-628-0791
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Authorized Official
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Title or Position | CLINICAL DIRECTOR
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Name | TRACY MUKLEWICZ
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Credential | MS ED, NCC, LCPC
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Telephone | 847-800-9347
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM1300X
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Taxonomy Name | Multi-Specialty Clinic/Center
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License Number |
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License Number State |
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