Organization
ANTIOCH CLINIC,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS A THAIN M.D. (PHYSICIAN)
(847) 395-1560
Entity
Organization
Contact information
Practice address
707 MAIN ST, ANTIOCH, IL 60002-1321
(847) 395-1560
(847) 395-4864
Mailing address
707 MAIN ST, ANTIOCH, IL 60002-1321
(847) 395-1560
(847) 395-4864
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
36070072
IL
Other
Enumeration date
02/14/2007
Last updated
08/22/2020
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