Organization
AMG ILLINOIS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY BAILET MD (PRESIDENT)
(414) 647-6322
Entity
Organization
Contact information
Practice address
81 E GRAND AVE, FOX LAKE, IL 60020-1557
(847) 587-0115
(847) 587-6246
Mailing address
81 E GRAND AVE, FOX LAKE, IL 60020-1557
(847) 587-0115
(847) 587-6246
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
04/21/2009
Last updated
08/31/2009
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