Organization · NPI-2
Medical Arts Clinic LLC
Anaplastologist · Chicago, IL
NPI number1669150728
StatusActive
Last updated in NPPESFeb 6, 2025
Details
- NPI
- 1669150728
- Entity type
- Organization (NPI-2)
- Legal business name
- Medical Arts Clinic LLC
- Organization subpart
- No
- Enumeration date
- Jul 10, 2023
- Certification date
- Feb 6, 2025
- Last updated
- Feb 6, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 229N00000X | Anaplastologist | – | – | Yes |
| 156FX1700X | Technician/Technologist, Ocularist | – | – |
Practice location
620 N La Salle Dr Ste 625Chicago, IL 60654-3708
Phone 832-725-5664
Mailing address
620 N La Salle Dr Ste 625Chicago, IL 60654-3708
Phone 832-725-5664
Authorized official
Eduardo Arias Amezquita
Anaplastologist /Ocularist
8327255664
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