Organization Name: | SUSANA C LAPID MDSC |
NPI Number: | 1043490485 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SUSANA LAPID (PRESIDENT) |
Mailing Address: | 380 E Northwest Hwy 3rd Floor Des Plaines |
State: | IL US |
Postal Code: | 600162290 |
Phone Number: | 8472964447 |
Fax Number: | 8473984779 |
NPI Enumeration Date: | 11/13/2007 |
NPI Last Update Date: | 02/14/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QP2300X |
License Number: | 036086867 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Primary Care |
Taxonomy Definition: |