Organization
CENTRAL CLINIC & RESEARCH SCIENCES INC
Active
Organization
CENTRAL CLINIC & RESEARCH SCIENCES INC
Active
Other names
Central Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
MYSORE BHAGAVAN MD (PRESIDENT)
(708) 275-7458
Entity
Organization
Contact information
Practice address
645 S CENTRAL AVE, CHICAGO, IL 60644-5059
(708) 275-7458
Mailing address
1224 RICHMOND AVE, WESTMONT, IL 60559-3300
(708) 275-7458
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-094099
IL
Other
Enumeration date
04/23/2018
Last updated
12/04/2019
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