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General NPI Number Information
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NPI Number | 1235663501
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Entity Type | Organization
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Legal Business Name | TRUE ISLAND MEDICAL CENTER
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Dates
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Enumeration Date | 04/13/2017
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Last Update Date | 04/13/2017
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Provider Practice Location Address
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Address Line | 1000 JORIE BLVD 370
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City | OAK BROOK
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State | IL
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Zip | 60523-2214
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Country | US
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Telephone | 331-305-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 1000 JORIE BLVD 370
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City | OAK BROOK
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State | IL
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Zip | 60523-2214
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGER
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Name | MARLA GUICE
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Credential |
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Telephone | 331-305-2816
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208VP0014X
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Taxonomy Name | Interventional Pain Medicine Physician
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License Number |
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License Number State |
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