Organization
A LOTA HEALTHCARE LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
EILEEN JOHNSON (DIRECTOR)
(708) 572-7606
Entity
Organization
Contact information
Practice address
10260 191ST ST STE 100, MOKENA, IL 60448-8802
(708) 572-7669
(708) 469-4358
Mailing address
9730 S WESTERN AVE STE 700, EVERGREEN PARK, IL 60805-2814
(708) 572-7669
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
207VF0040X
Urogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
—
—
261QR1100X
Research Clinic/Center
—
—
Other
Enumeration date
12/08/2020
Last updated
01/17/2022
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