Organization
ADOLESCENT AND YOUNG ADULT PLACE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARGO ANTOINETTE BELL M.D. (OWNER)
(312) 859-2491
Entity
Organization
Contact information
Practice address
9 N CICERO AVE, CHICAGO, IL 60644-3602
(312) 859-2491
Mailing address
PO BOX 795, HILLSIDE, IL 60162-0795
(708) 544-6553
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
036086432
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036086432
—
IL
Enumeration date
12/03/2010
Last updated
12/03/2010
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