Adolescent And Young Adult Place Ltd
Pediatrics, Adolescent Medicine in Chicago, IL. Organization (NPI-2).
NPI number1417259979
StatusActive
Last updated in NPPESDec 3, 2010
Details
- NPI
- 1417259979
- Entity type
- Organization (NPI-2)
- Legal business name
- Adolescent And Young Adult Place Ltd
- Organization subpart
- No
- Enumeration date
- Dec 3, 2010
- Last updated
- Dec 3, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2080A0000X | Pediatrics, Adolescent Medicine | 036086432 | IL | Yes |
Practice location
9 N Cicero AveChicago, IL 60644-3602
Phone 312-859-2491
Mailing address
Po Box 795Hillside, IL 60162-0795
Phone 708-544-6553
Authorized official
Margo Antoinette Bell
Owner
3128592491
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