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Organization

GEORGE E DEPHILLIPS MD SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
GEORGE E DEPHILLIPS MD (PRESIDENT)
(815) 741-2312
Entity
Organization

Contact information

Practice address
903 N 129TH INFANTRY DR STE 200, JOLIET, IL 60435-5002
(815) 741-2312
Mailing address
903 N 129TH INFANTRY DR STE 200, JOLIET, IL 60435-5002
(815) 741-2312

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036073278
IL

Other

Enumeration date
05/14/2012
Last updated
05/14/2012
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