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General NPI Number Information
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NPI Number | 1497060024
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Entity Type | Organization
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Legal Business Name | OAK LAWN IMMEDIATE CARE LLC
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Dates
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Enumeration Date | 08/06/2010
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Last Update Date | 08/06/2010
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Provider Practice Location Address
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Address Line | 4201 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2615
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Country | US
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Telephone | 708-499-7661
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Fax |
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Provider Business Mailing Address
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Address Line | 4201 W 95TH ST
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City | OAK LAWN
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State | IL
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Zip | 60453-2615
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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 | OWNER
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Name | DR. JERZY SZYMANSKI
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Credential | MD
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Telephone | 773-735-8038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number | 036085357
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License Number State | IL
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