Organization
AMG ILLINOIS LTD
Active
Other names
AMG Illinois
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W BAILET MD (PRESIDENT)
(414) 647-6322
Entity
Organization
Contact information
Practice address
3115 LEWIS AVE, ZION, IL 60099-3096
(847) 746-3752
Mailing address
3115 LEWIS AVE, ZION, IL 60099-3096
(847) 746-3752
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
07/06/2011
Last updated
12/07/2012
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