Organization
JENCARE NEIGHBORHOOD MEDICAL CENTER BERWYN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY CHEN (AUTHORIZED OFFICIAL)
(305) 831-4722
Entity
Organization
Contact information
Practice address
6326 CERMAK RD, BERWYN, IL 60402-2304
(305) 628-6117
Mailing address
1395 NW 167TH ST, MIAMI, FL 33169-5710
(302) 628-6117
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036.131322
IL
332900000X
Non-Pharmacy Dispensing Site
036.131322
IL
Other
Enumeration date
04/05/2013
Last updated
10/31/2024
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