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General NPI Number Information
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NPI Number | 1215921952
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Entity Type | Organization
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Legal Business Name | PAHCS II
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Dates
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Enumeration Date | 09/08/2005
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 245 S GARY AVE STE 101
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2228
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Country | US
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Telephone | 630-894-8404
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Fax | 630-894-8028
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Provider Business Mailing Address
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Address Line | 245 S GARY AVE STE 101
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City | BLOOMINGDALE
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State | IL
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Zip | 60108-2228
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Country | US
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Telephone | 630-894-8404
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Fax | 630-894-8028
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Authorized Official
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Title or Position | ACCOUNTS RECEIVABLE SUPERVISOR
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Name | MISS MINDY E YEP SR.
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Credential |
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Telephone | 630-539-5275
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QX0100X
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Taxonomy Name | Occupational Medicine Clinic/Center
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License Number |
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License Number State |
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