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General NPI Number Information
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NPI Number | 1790183242
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Entity Type | Organization
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Legal Business Name | BIOMEDICAL CONCEPTS
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Dates
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Enumeration Date | 12/16/2014
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Last Update Date | 12/16/2014
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Provider Practice Location Address
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Address Line | 715 LAKE ST SUITE 500
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City | OAK PARK
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State | IL
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Zip | 60301-1422
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Country | US
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Telephone | 708-445-9691
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Fax | 708-445-9692
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Provider Business Mailing Address
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Address Line | 715 LAKE ST SUITE 500
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City | OAK PARK
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State | IL
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Zip | 60301-1422
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Country | US
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Telephone | 708-445-9691
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Fax | 708-445-9692
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. CARLOS WANES BEDROSSIAN
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Credential | M.D.
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Telephone | 708-445-9691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251B00000X
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Taxonomy Name | Case Management Agency
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License Number | 036096740
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License Number State | IL
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