Organization
VEIN CARE INSTITUTE, LLC
Active
Other names
Premier Vascular Laboratory
Organization subpart
No
Provider details
NPI number
Authorized official
EUGENE M TANQUILUT D.O. (MEMBER)
(708) 305-0248
Entity
Organization
Contact information
Practice address
3736 W 26TH ST, CHICAGO, IL 60623-3826
(773) 277-1100
Mailing address
16406 PEPPERWOOD TRL, ORLAND HILLS, IL 60487-5644
(708) 305-2620
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
02/08/2008
Last updated
02/08/2008
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