Organization
GEL M GOWIN,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELITA M GOWIN (OWNER)
(708) 425-4162
Entity
Organization
Contact information
Practice address
3541 W 95TH ST, EVERGREEN PARK, IL 60805-2135
(708) 425-4162
(708) 425-8708
Mailing address
3541 W 95TH ST, EVERGREEN PARK, IL 60805-2135
(708) 425-4162
(708) 425-8708
Taxonomy
Speciality
Code
Description
License number
State
332H00000X
Eyewear Supplier
Primary
37582585
IL
Other
Enumeration date
03/02/2010
Last updated
03/02/2010
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