Organization
CLINICA SU RED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. BRENT J RHODE M.S. (CHIEF OPERATING OFFICER)
(708) 337-7704
Entity
Organization
Contact information
Practice address
720 COLLINS ST, JOLIET, IL 60432-1615
(815) 726-2288
(815) 726-2814
Mailing address
5241 S CICERO AVE, CHICAGO, IL 60632-4967
(708) 364-8441
(708) 364-8443
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
—
—
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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