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Organization
SELECT MED NETWORK
Active
Organization
SELECT MED NETWORK
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKY CHIAKULAS (PRESIDENT)
(847) 687-9535
Entity
Organization
Contact information
Practice address
901 N QUINCE LN, MOUNT PROSPECT, IL 60056-1501
(847) 687-9535
Mailing address
9 S ELMHURST RD UNIT 350, PROSPECT HEIGHTS, IL 60070-7912
(847) 687-9535
Taxonomy
Speciality
Code
Description
License number
State
261QC1800X
Corporate Health Clinic/Center
Primary
—
NULL
Other
Enumeration date
05/20/2022
Last updated
06/01/2022
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