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Organization
HSSI MCO SPV LLC
Active
Organization
HSSI MCO SPV LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMY OWENS (DIRECTOR , FINANCE)
(815) 300-7106
Entity
Organization
Contact information
Practice address
1851 SILVER CROSS BLVD, STE 110, NEW LENOX, IL 60451
(815) 300-3060
Mailing address
1900 SILVER CROSS BLVD, NEW LENOX, IL 60451-9509
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
NULL
207Q00000X
Family Medicine Physician
—
—
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
207T00000X
Neurological Surgery Physician
—
NULL
207T00000X
Neurological Surgery Physician
—
—
208600000X
Surgery Physician
—
NULL
208600000X
Surgery Physician
—
—
Other
Enumeration date
02/01/2021
Last updated
02/01/2021
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