Individual
TONY A EDEH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7 BOULDER RIDGE CT, BOLINGBROOK, IL 60490-5534
(630) 300-4202
(630) 759-8636
Mailing address
7 BOULDER RIDGE CT, BOLINGBROOK, IL 60490-5534
(630) 300-4202
(630) 759-8636
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
—
IL
172A00000X
Driver
Primary
—
—
Other
Enumeration date
07/06/2017
Last updated
07/21/2022
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