Organization
LJ MEDICATION, LTD.
Active
Parent organization
LA CLINICA, S.C.
Other names
La Clinica
Organization subpart
Yes
Provider details
NPI number
Legal business name
LA CLINICA, S.C.
Authorized official
DR. EUGENE MARIO JAO DC (PRESIDENT)
(773) 278-9525
Entity
Organization
Contact information
Practice address
1101 WASHINGTON ST, WAUKEGAN, IL 60085-5301
(773) 278-9525
Mailing address
PO BOX 4782, CHICAGO, IL 60680-4782
Taxonomy
Speciality
Code
Description
License number
State
111NR0400X
Rehabilitation Chiropractor
—
—
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
10/01/2019
Last updated
10/01/2019
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