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General NPI Number Information
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NPI Number | 1851760839
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Entity Type | Organization
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Legal Business Name | ALLIANCE LABORIST GROUP S.C.
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Dates
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Enumeration Date | 09/19/2015
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Last Update Date | 09/19/2015
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Provider Practice Location Address
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Address Line | 3114 OAK PARK AVE
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City | BERWYN
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State | IL
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Zip | 60402-3031
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Country | US
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Telephone | 708-788-2038
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Fax |
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Provider Business Mailing Address
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Address Line | 3114 OAK PARK AVE
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City | BERWYN
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State | IL
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Zip | 60402-3031
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Country | US
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Telephone | 708-788-2038
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | DR. RAMESH SEERAS
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Credential | M.D.
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Telephone | 708-788-2038
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208M00000X
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Taxonomy Name | Hospitalist Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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