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Organization

PASSPORT ENTERPRISES LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ELIZABETH CAPRON (BUSINESS MANAGER)
(817) 681-3775
Entity
Organization

Contact information

Practice address
250 CENTER DR STE 202, VERNON HILLS, IL 60061-1582
(847) 816-3434
Mailing address
250 CENTER DR STE 202, VERNON HILLS, IL 60061-1582
(847) 816-3434

Taxonomy

Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
036099609
IL

Other

Enumeration date
07/03/2008
Last updated
07/03/2008
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