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Organization
PICC LINE CO, INC
Active
Organization
PICC LINE CO, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MOHAMMAD RAZZAQUE MD (PRESIDENT)
(773) 767-7666
Entity
Organization
Contact information
Practice address
6449 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 767-7666
Mailing address
6449 S PULASKI RD, CHICAGO, IL 60629-5148
(773) 767-7666
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036089799
IL
Other
Enumeration date
05/04/2011
Last updated
05/04/2011
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