Organization · NPI-2

Alliance Internal Medicine, S.C.

Internal Medicine · Bourbonnais, IL

NPI number1710120696
StatusActive
Last updated in NPPESMay 3, 2010

Details

NPI
1710120696
Entity type
Organization (NPI-2)
Legal business name
Alliance Internal Medicine, S.C.
Organization subpart
No
Enumeration date
Apr 8, 2009
Last updated
May 3, 2010

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
207R00000X Internal Medicine036090542ILYes
207R00000X Internal Medicine036090440IL
207R00000X Internal Medicine036108040IL

Practice location

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914

Phone 815-523-2070 · Fax 815-523-7022

Mailing address

370 Larry Power Rd
Suite 2
Bourbonnais, IL 60914-5193

Phone 815-523-7020 · Fax 815-523-7022

Authorized official

Saw M Oo
President
8155232070

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