Organization · NPI-2

395061 Med Eval

Psychiatric Unit · Chicago, IL

NPI number1508034414
StatusActive
Last updated in NPPESFeb 13, 2008

Details

NPI
1508034414
Entity type
Organization (NPI-2)
Legal business name
395061 Med Eval
Organization subpart
Yes
Enumeration date
Feb 13, 2008
Last updated
Feb 13, 2008

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
273R00000X Psychiatric Unit––Yes

Practice location

4200 North Oak Park Avenue
Chicago, IL 60634-1417

Phone 773-794-3733 · Fax 773-794-4046

Mailing address

4200 North Oak Park Avenue
Chicago, IL 60634-1417

Phone 773-794-3733 · Fax 773-794-4046

Authorized official

Angie C Tansor
Reimbursement Officer I
7737943733

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