Organization
CASILLO ENTERPRISES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRIAN LERNER (PRESIDENT)
(312) 868-7166
Entity
Organization
Contact information
Practice address
4924 W DEMING PL, CHICAGO, IL 60639-2521
(312) 868-7166
Mailing address
4924 W DEMING PL, CHICAGO, IL 60639-2521
(312) 868-7166
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
291U00000X
Clinical Medical Laboratory
Primary
—
—
333600000X
Pharmacy
—
—
Other
Enumeration date
11/23/2021
Last updated
01/14/2022
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