Beverly Bone And Joint Clinic LLC
Anesthesiology, Pain Medicine in Chicago, IL. Organization (NPI-2).
NPI number1649052002
StatusActive
Last updated in NPPESOct 26, 2023
Details
- NPI
- 1649052002
- Entity type
- Organization (NPI-2)
- Legal business name
- Beverly Bone And Joint Clinic LLC
- Organization subpart
- No
- Enumeration date
- Oct 19, 2023
- Certification date
- Oct 26, 2023
- Last updated
- Oct 26, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207LP2900X | Anesthesiology, Pain Medicine | – | – | Yes |
| 111N00000X | Chiropractor | – | – | |
| 207L00000X | Anesthesiology | – | – |
Practice location
10448 S Western AveChicago, IL 60643-2508
Phone 708-360-3507
Mailing address
10448 S Western AveChicago, IL 60643-2508
Authorized official
Nathan Smith
Biller
8103588749
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