Organization Name: | GREAT OAKS MEDICAL CARE SC |
NPI Number: | 1003851122 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | DUANE LAMBERT (OWNER) |
Mailing Address: | 2425 W 22nd St Suite 206 Oak Brook |
State: | IL US |
Postal Code: | 605231245 |
Phone Number: | 6303356228 |
Fax Number: | 6309902998 |
NPI Enumeration Date: | 06/20/2006 |
NPI Last Update Date: | 07/06/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 036109590 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |