HAROLD E DAVIS & TERRY ALAN TRUST
Managed Care Organizations at 95 St, Oak Lawn, IL

License number
Illinois 046007173
Category
Managed Care Organizations
Type
Preferred Provider Organization
License number
Illinois 046009277
Category
Managed Care Organizations
Type
Preferred Provider Organization
License number
Illinois 046004083
Category
Managed Care Organizations
Type
Preferred Provider Organization
Owner
Name: MS. LINDA S. ROSE
Title: ADMINISTRATIVE ASST.
Phone: (708) 636-0600
Address
Address
4663 W 95Th St, Oak Lawn, IL 60453
National Provider ID: 1265621361
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

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