Organization
POLISH AMERICAN ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. GARY KENZER (EXECUTIVE DIRECTOR)
(773) 427-6317
Entity
Organization
Contact information
Practice address
3834 N CICERO AVE, ATTN: ACCOUNTING DEPARTMENT, CHICAGO, IL 60641-3622
(773) 282-8206
(773) 282-1324
Mailing address
3834 N CICERO AVE, ATTN: ACCOUNTING DEPARTMENT, CHICAGO, IL 60641-3622
(773) 282-8206
(773) 282-1324
Taxonomy
Speciality
Code
Description
License number
State
253Z00000X
In Home Supportive Care Agency
Primary
1346682614
IL
Other
Enumeration date
03/12/2014
Last updated
03/12/2014
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