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Organization

NOCD ILLINOIS PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
LARRY TRUSKY (COO)
(312) 569-0820
Entity
Organization

Contact information

Practice address
6160 N CICERO AVE, CHICAGO, IL 60646
(312) 569-0820
Mailing address
225 N MICHIGAN AVE STE 1430, CHICAGO, IL 60601-7653
(312) 569-0820

Taxonomy

Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary

Other

Enumeration date
04/02/2020
Last updated
04/07/2020
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