Organization
INTERACTIVE HEALTHCARE OF CENTRAL ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. PAUL GOSSMAN (PRESIDENT)
(708) 344-7930
Entity
Organization
Contact information
Practice address
1701 S 1ST AVE, SUITE 503, MAYWOOD, IL 60153-2442
(708) 344-7930
(708) 344-7932
Mailing address
1701 S 1ST AVE, SUITE 503, MAYWOOD, IL 60153-2442
(708) 344-7930
(708) 344-7932
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
1011482
IL
Other
Enumeration date
06/15/2011
Last updated
06/15/2011
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