PREVENTIVE CARDIOVASCULAR SERVICES SC
Osteopathic Medicine at Superior St, Chicago, IL

License number
Illinois 036081595
Category
Osteopathic Medicine
Type
Cardiovascular Disease
Owner
Name: ALAN JACKSON MD
Title: PRESIDENT
Phone: (708) 479-6522
Address
Address 2
356 W Superior St FL 2, Chicago, IL 60654
PO Box 187, Tinley Park, IL 60477
National Provider ID: 1306914791
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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PREVENTIVE CARDIOVASCULAR SERVICES, S.C

Alan L Jackson, Chicago, IL 60643

Status:
Inactive
Registration:
Dec 8, 2005
State ID:
64578324
Business type:
DOMESTIC BCA
Expiration:
PERPETUAL
Agent:
Oran F Whiting,131 S Dearborn St STE 3000, Chicago, IL 60603 (Physical)

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