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Organization
CORNERSTONE FAMILY HEALTH S.C.
Active
Organization
CORNERSTONE FAMILY HEALTH S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. IRENE THOMAS-THEVATHERIL M.D. (PRESIDENT)
(630) 734-0580
Entity
Organization
Contact information
Practice address
3080 OGDEN AVE STE 204, LISLE, IL 60532-1694
(630) 734-0580
(630) 734-0581
Mailing address
PO BOX 534, LISLE, IL 60532-0534
(630) 734-0580
(630) 734-0581
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
036105417
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036105417
—
IL
Enumeration date
12/07/2006
Last updated
03/01/2021
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