Organization Name: | A & E INTEGRATED HEALTH, S.C. |
NPI Number: | 1457631475 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | MICHAEL BOZZONE (EXECUTIVE DIRECTOR) |
Mailing Address: | 656 N Independence Blvd Romeoville |
State: | IL US |
Postal Code: | 604461374 |
Phone Number: | 8158869500 |
Fax Number: | 8158869800 |
NPI Enumeration Date: | 08/22/2011 |
NPI Last Update Date: | 11/08/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 036124389 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |