Organization
LAGRANGE FAMILY CARE CENTER LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH Z. HURA M.D. (DIRECTOR)
(708) 354-3000
Entity
Organization
Contact information
Practice address
412 SHERWOOD RD, LA GRANGE PARK, IL 60526-1968
(708) 354-3000
(708) 354-5835
Mailing address
412 SHERWOOD RD, LA GRANGE PARK, IL 60526-1968
(708) 354-3000
(708) 354-5835
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036069372
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036069372
—
IL
Enumeration date
09/07/2007
Last updated
02/12/2015
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