Organization
FAMILY MEDICAL CENTER OF BOLINGBROOK SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTONIO CARLINO D.O. (OWNER)
(630) 739-2878
Entity
Organization
Contact information
Practice address
516 E BOUGHTON RD, BOLINGBROOK, IL 60440-2181
(630) 739-2878
Mailing address
516 E BOUGHTON RD, BOLINGBROOK, IL 60440-2181
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036-098970
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
556070
MEDICARE GRP#
IL
Enumeration date
03/20/2007
Last updated
05/26/2010
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