Organization
FAMILY HEALTH CENTER PHYSICIANS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEROME T DALY DO (PRESIDENT)
(815) 469-8806
Entity
Organization
Contact information
Practice address
20325 S GRACELAND LN, FRANKFORT, IL 60423-9047
(815) 469-8806
(815) 469-5739
Mailing address
20325 S GRACELAND LN, FRANKFORT, IL 60423-9047
(815) 469-8806
(815) 469-5739
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
09932131
BLUE SHIELD
IL
Enumeration date
03/23/2007
Last updated
08/22/2020
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