| Charm Development LLC | |
|
515 W 14th St Unit C Chicago Heights IL 60411-2456 | |
| (708) 503-1105 | |
| Not Available |
| Full Name | Charm Development LLC |
|---|---|
| Speciality | Family Medicine |
| Location | 515 W 14th St, Chicago Heights, Illinois |
| Authorized Official Name and Position | Bryan Day (CEO) |
| Authorized Official Contact | 7085031105 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Charm Development LLC 515 W 14th St Unit C Chicago Heights IL 60411-2456 Ph: (708) 503-1105 | Charm Development LLC 515 W 14th St Unit C Chicago Heights IL 60411-2456 Ph: (708) 503-1105 |
| NPI Number | 1164687869 |
|---|---|
| Provider Enumeration Date | 07/22/2008 |
| Last Update Date | 07/22/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164687869 | NPI | - | NPPES |
| 036035802 | Medicaid | IL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 036035802 (Illinois) | Primary |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 335-027231 (Illinois) | Secondary |
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