Organization
ALPHA FERTILITY ADVANCE LTO
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GRACE LOS (MANAGER)
(815) 919-9499
Entity
Organization
Contact information
Practice address
1515 ESSINGTON RD, JOLLET, IL 60435-2879
(815) 919-9499
(815) 730-1066
Mailing address
1515 ESSINGTON RD, JOLLET, IL 60435-2879
(815) 919-9499
(815) 730-1066
Taxonomy
Speciality
Code
Description
License number
State
261QF0050X
Non-Surgical Family Planning Clinic/Center
Primary
—
—
Other
Enumeration date
06/11/2020
Last updated
06/11/2020
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