Organization
EARLESIAN HEALTH CONCEPTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LUCIUS C EARLES III M.D. (OWNER)
(708) 283-5049
Entity
Organization
Contact information
Practice address
20815 BROOKSIDE BLVD, OLYMPIA FIELDS, IL 60461-1712
(708) 283-5049
Mailing address
20815 BROOKSIDE BLVD, OLYMPIA FIELDS, IL 60461-1712
(708) 283-5049
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036042961
IL
Other
Enumeration date
05/23/2012
Last updated
05/23/2012
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