Organization
AZZIZAWEAR INTERNATIONAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JUANITA J. LACOURT-GRANT (PRESIDENT/CEO)
(708) 524-9900
Entity
Organization
Contact information
Practice address
817 SOUTH SCOVILLE AVENUE, SUITE 3A, OAK PARK, IL 60304-1408
(708) 524-9900
(708) 524-3399
Mailing address
817 SOUTH SCOVILLE AVENUE, SUITE 3A, OAK PARK, IL 60304-1408
(708) 524-9900
(708) 524-3399
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/08/2008
Last updated
08/08/2008
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