Organization
TEAM ANTI-AGING CENTER INC
Active
Other names
Team Doctors
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAMES STOXEN (PRESIDENT)
(773) 735-5200
Entity
Organization
Contact information
Practice address
222 W ONTARIO ST, SUITE 503, CHICAGO, IL 60654-3652
(773) 735-5200
(773) 735-8656
Mailing address
222 W ONTARIO ST, SUITE 503, CHICAGO, IL 60654-3652
(773) 735-5200
(773) 735-8656
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
038005767
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038005767
ILLINOIS STATE LICENSE NUMBER
IL
Enumeration date
03/09/2016
Last updated
03/09/2016
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