Organization
SOLID ROCK CARE CENTER II
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LARRY SMITH (CEO)
(708) 358-8040
Entity
Organization
Contact information
Practice address
228 MADISON ST, OAK PARK, IL 60302-4194
(708) 358-8040
(708) 358-8049
Mailing address
228 MADISON ST, OAK PARK, IL 60302-4194
(708) 358-8040
(708) 358-8049
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6030201
—
IL
Enumeration date
08/21/2007
Last updated
08/13/2008
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