Organization
AMG ILLINOIS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY W BAILET MD (PRESIDENT)
(414) 647-3047
Entity
Organization
Contact information
Practice address
7505 GRAND AVE, GURNEE, IL 60031-1551
(847) 746-3752
Mailing address
7505 GRAND AVE, GURNEE, IL 60031-1551
(847) 746-3752
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Enumeration date
08/23/2011
Last updated
12/19/2011
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