Organization
HEALTHSTOP SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MANOHAR JETHANI MD (PRESIDENT)
(708) 447-9402
Entity
Organization
Contact information
Practice address
3635 S HARLEM AVE, BERWYN, IL 60402-3212
(708) 447-9402
(708) 447-3246
Mailing address
3635 S HARLEM AVE, BERWYN, IL 60402-3212
(708) 447-9402
(708) 447-3246
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Enumeration date
08/12/2019
Last updated
08/12/2019
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