Organization · Type 2 NPI
Blackbag Home Physician Service LLC
Health Service Clinic/Center · Park Forest, IL
NPI number
1770824161
Active
Practice location
437 Navajo St
Park Forest, IL 60466-2520
Fax (888) 311-8610
Mailing address
21200 S Lagrange Rd, 305
Frankfort, IL 60423-2003
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Health Service Clinic/Center Primary | 261QH0100X | None listed |
Health Service Clinic/Center: Definition to come...
About NPI 1770824161
Blackbag Home Physician Service LLC's National Provider Identifier is 1770824161, issued on Mar 9, 2013. The primary taxonomy on file is Health Service Clinic/Center (261QH0100X), and the practice location is in Park Forest, IL. The record was last updated on Dec 21, 2014.