Organization
SOUTHWEST MANAGEMENT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VICKI GAW (OFFICE MANAGER)
(708) 425-9096
Entity
Organization
Contact information
Practice address
4861 W 95TH ST, OAK LAWN, IL 60453-2521
(708) 425-9096
Mailing address
4861 W 95TH ST, OAK LAWN, IL 60453-2521
(708) 425-9096
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
—
IL
Other
Enumeration date
11/27/2007
Last updated
11/27/2007
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