Organization
CRAVE COOKIE BERWYN LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ASIM MOHAMMAD BALLOUT (CEO)
(708) 510-4721
Entity
Organization
Contact information
Practice address
600 W 65TH ST APT 5, WESTMONT, IL 60559-2856
(708) 510-4721
Mailing address
600 W 65TH ST APT 5, WESTMONT, IL 60559-2856
(708) 510-4721
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
07/18/2025
Last updated
07/18/2025
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