Organization
APACHE INTERPRETATIONS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID G VERMILLION MD (PRESIDENT)
(708) 828-7500
Entity
Organization
Contact information
Practice address
150 W HIGH ST, MORRIS, IL 60450-1463
(708) 828-7500
Mailing address
PO BOX 301, MINOOKA, IL 60447-0301
(708) 828-7500
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0003222913
BLUE CROSS BLUE SHIELD ID
IL
Enumeration date
04/25/2007
Last updated
06/29/2012
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