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Organization
PEM MEDICAL SC CENTRO MEDICO
Active
Organization
PEM MEDICAL SC CENTRO MEDICO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EDGAR E ARCHBOLD M.D. (PHYSICIAN)
(708) 484-9079
Entity
Organization
Contact information
Practice address
6925 CERMAK RD, BERWYN, IL 60402-2248
(708) 484-9079
(708) 749-8190
Mailing address
PO BOX 1206, N RIVERSIDE, IL 60546-0606
(708) 484-9079
(708) 749-8190
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
02/23/2012
Last updated
03/15/2012
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