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Organization

BLUE ISLAND MEDICAL SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EUGENE M JAO MD (PRESIDENT)
(312) 961-6611
Entity
Organization

Contact information

Practice address
12943 WESTERN AVE, BLUE ISLAND, IL 60406-2416
(773) 278-9525
(773) 337-9135
Mailing address
PO BOX 4782, CHICAGO, IL 60680-4782
(773) 273-9525
(773) 337-9135

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary

Other

Enumeration date
09/09/2022
Last updated
09/26/2022
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