Organization
ADVANCED LIFE PROVIDERS
Active
Organization
ADVANCED LIFE PROVIDERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LA TONYA LEE RAFE RN (CEO)
(847) 830-7385
Entity
Organization
Contact information
Practice address
239 WILLOW RD, MATTESON, IL 60443-1068
(847) 830-7385
Mailing address
239 WILLOW RD, MATTESON, IL 60443-1068
(847) 830-7385
Taxonomy
Speciality
Code
Description
License number
State
174H00000X
Health Educator
Primary
041348482
IL
Other
Enumeration date
04/10/2017
Last updated
04/10/2017
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