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General NPI Number Information
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NPI Number | 1235354713
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Entity Type | Organization
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Legal Business Name | JOLIET OUTPATIENT CENTER, LLC
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Dates
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Enumeration Date | 04/17/2007
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Last Update Date | 04/18/2011
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Provider Practice Location Address
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Address Line | 823 129TH INFANTRY DR SUITE 102
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City | JOLIET
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State | IL
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Zip | 60435-8346
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Country | US
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Telephone | 815-730-9888
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Fax | 815-741-9868
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Provider Business Mailing Address
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Address Line | 823 129TH INFANTRY DR SUITE 102
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City | JOLIET
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State | IL
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Zip | 60435-8346
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Country | US
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Telephone | 815-730-9888
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Fax | 815-741-9868
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Authorized Official
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Title or Position | MANAGER
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Name | DR. ALAN H. CHEN
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Credential | M.D.
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Telephone | 815-730-9888
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number |
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License Number State |
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