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Organization

BLUE DIAMOND HEALTH CARE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JAMES JAMES VACRACOS PA-C (PHYSICIAN ASSISTANT)
(219) 765-3431
Entity
Organization

Contact information

Practice address
2749 W NORTH AVE, CHICAGO, IL 60647-5246
(773) 292-9660
Mailing address
2749 W NORTH AVE, CHICAGO, IL 60647-5246
(773) 292-9660

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
363AM0700X
Medical Physician Assistant

Other

Enumeration date
04/05/2010
Last updated
04/05/2010
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