Organization
FLAWLESS SERVICE CORPORATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. REGINA PORTER R.N. (PRESIDENT)
(312) 222-0030
Entity
Organization
Contact information
Practice address
2555 S KING DR, 2ND FLOOR, CHICAGO, IL 60616-2419
(312) 222-0030
Mailing address
2555 S KING DR, 2ND FLOOR, CHICAGO, IL 60616-2419
(312) 222-0030
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
IL
Other
Enumeration date
07/10/2012
Last updated
12/05/2012
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