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Evergreen Care Center Ltd
General Practice Physician in Evergreen Park, Illinois
NPI 1447449616

Evergreen Care Center Ltd is a General Practice Physician based in Evergreen Park, IL. Evergreen Care Center Ltd practices in Evergreen Park, IL. The NPI Number for Evergreen Care Center Ltd is 1447449616 and holds a License No. (Illinois).

The current practice location address for Evergreen Care Center Ltd is 9760 S Kedzie Ave, Evergreen Park, IL and can be reached out via phone at 708-423-6209 and via fax at 708-423-9021.

Location: 9760 S Kedzie Ave, Evergreen Park, IL, 60805-3109
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1447449616
Provider Name
Evergreen Care Center Ltd
Credential
Provider Entity Type
Organization
Address
9760 S Kedzie Ave, Evergreen Park, IL, 60805-3109
Phone Number
708-423-6209
Fax Number
708-423-9021
Provider Enumeration Date
10/23/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
DA0131 01 IL RAIL ROAD MEDICARE
036084895 05 IL
institution
Provider Business Practice Location Address Details
Address
9760 S Kedzie Ave
City
Evergreen Park
State
Illinois
Zip
60805-3109
Phone Number
708-423-6209
Fax Number
708-423-9021
person
Provider Business Mailing Address Details
Address
9760 S Kedzie Ave
City
Evergreen Park
State
Illinois
Zip
60805-3109
Phone Number
708-423-6209
Fax Number
708-423-9021
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
208D00000X
License No.
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Definition
Definition to come...
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