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Organization
FAMILY MEDICAL CENTER OF BOLINGBROOK SC
Active
Organization
FAMILY MEDICAL CENTER OF BOLINGBROOK SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO CARLINO D.O. (OWNER)
(630) 739-2878
Entity
Organization
Contact information
Practice address
516 E BOUGHTON RD, BOLINGBROOK, IL 60440-2181
(630) 739-2878
Mailing address
516 E BOUGHTON RD, BOLINGBROOK, IL 60440-2181
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036-098970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
556070
MEDICARE GRP#
IL
Enumeration date
03/20/2007
Last updated
05/26/2010
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