Organization
LIVE NFP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ROBERT VARNADO (PRESIDENT)
(773) 419-0131
Entity
Organization
Contact information
Practice address
9016 S INDIANA AVE, CHICAGO, IL 60619-6638
(773) 419-0131
Mailing address
9016 S INDIANA AVE, CHICAGO, IL 60619-6638
(773) 419-0131
Taxonomy
Speciality
Code
Description
License number
State
347C00000X
Private Vehicle
Primary
V65377255029
IL
Other
Enumeration date
06/06/2014
Last updated
06/06/2014
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