Organization
PRINCE&PRINCESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NIMAT NIKE AKOREDE RN (OWNER)
(708) 374-1159
Entity
Organization
Contact information
Practice address
3630 214TH PL, MATTESON, IL 60443-2704
(708) 374-1159
Mailing address
3630 214TH PL, MATTESON, IL 60443-2704
(708) 374-1159
Taxonomy
Speciality
Code
Description
License number
State
261QI0500X
Infusion Therapy Clinic/Center
Primary
041402048
IL
Other
Enumeration date
02/05/2015
Last updated
02/05/2015
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