Organization
RICO MEDICAL OFFICE, CORP.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WILLIAM CAWLEY (MANAGER)
(773) 525-8744
Entity
Organization
Contact information
Practice address
646 W WELLINGTON AVE APT 2E, CHICAGO, IL 60657-9330
(773) 525-8744
Mailing address
646 W WELLINGTON AVE APT 2E, CHICAGO, IL 60657-9330
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
—
—
2084P2900X
Pain Medicine (Psychiatry & Neurology) Physician
—
—
208VP0000X
Pain Medicine Physician
Primary
—
—
Other
Enumeration date
12/13/2013
Last updated
12/13/2013
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