Organization
LORETTA L BAYLESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS LORETTA L BAYLESS (OWNER)
(312) 962-4415
Entity
Organization
Contact information
Practice address
15813 CLIFTON PARK AVE, MARKHAM, IL 60428-3920
(312) 962-4415
(708) 234-7348
Mailing address
15813 CLIFTON PARK AVE, MARKHAM, IL 60428-3920
(312) 962-4415
(708) 234-7348
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
9737286
IL
Other
Enumeration date
04/06/2009
Last updated
04/06/2009
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