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General NPI Number Information
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NPI Number | 1851500854
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Entity Type | Organization
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Legal Business Name | J I L MEDICAL CONSULTANCY LTD
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Dates
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Enumeration Date | 05/22/2007
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Last Update Date | 05/10/2019
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Provider Practice Location Address
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Address Line | 6307 S STEWART AVE
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City | CHICAGO
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State | IL
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Zip | 60621-3116
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Country | US
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Telephone | 773-776-8800
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Fax | 773-776-8801
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Provider Business Mailing Address
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Address Line | 5500 S DAMEN AVE
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City | CHICAGO
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State | IL
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Zip | 60636-1107
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Country | US
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Telephone | 773-776-8800
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Fax | 773-776-8801
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Authorized Official
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Title or Position | PRACTICE ADMINISTRATOR
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Name | TADE O AKERE
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Credential | M.B.A
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Telephone | 773-776-8800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 036094343
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License Number State | IL
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