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General NPI Number Information
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NPI Number | 1386427011
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Entity Type | Organization
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Legal Business Name | JUAN COMMUNICATIONS INC
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Dates
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Enumeration Date | 08/16/2023
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 21750 MAIN ST UNIT 11
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City | MATTESON
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State | IL
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Zip | 60443-3717
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Country | US
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Telephone | 312-832-6662
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Fax | 312-761-2938
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Provider Business Mailing Address
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Address Line | 3114 BONNIE BRAE CRES
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City | FLOSSMOOR
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State | IL
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Zip | 60422-2030
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Country | US
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Telephone | 773-619-9625
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MRS. ELJUANDA JONES-GRAHAM
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Credential | LAB DIRECTOR
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Telephone | 312-832-6662
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 246RM2200X
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Taxonomy Name | Medical Laboratory Technician
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License Number |
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License Number State |
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