Organization · NPI-2

1920 Medical Center

· Oak Brook, IL

NPI number1881140804
StatusActive
Last updated in NPPESDec 7, 2016

Details

NPI
1881140804
Entity type
Organization (NPI-2)
Legal business name
1920 Medical Center
Organization subpart
No
Enumeration date
Aug 30, 2016
Last updated
Dec 7, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
208VP0000X ––Yes

Practice location

1000 Jorie Blvd
Suite 370
Oak Brook, IL 60523-2214

Phone 330-305-2813

Mailing address

1920 Country Place Pkwy
Suite 342
Pearland, TX 77584-2282

Authorized official

Marla Guice
Marla
3313052813

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