| Healthy Connection Physical Medicine Inc | |
|
16626 W 159th St Suite700 Lockport IL 60441-8018 | |
| (815) 834-9075 | |
| (815) 834-9077 |
| Full Name | Healthy Connection Physical Medicine Inc |
|---|---|
| Speciality | General Practice |
| Location | 16626 W 159th St, Lockport, Illinois |
| Authorized Official Name and Position | Victor Puodziunas (TREASURER) |
| Authorized Official Contact | 8158349075 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Healthy Connection Physical Medicine Inc 16626 W 159th St Suite700 Lockport IL 60441-8018 Ph: (815) 834-9075 | Healthy Connection Physical Medicine Inc 16626 W 159th St Suite700 Lockport IL 60441-8018 Ph: (815) 834-9075 |
| NPI Number | 1770860124 |
|---|---|
| Provider Enumeration Date | 11/14/2011 |
| Last Update Date | 08/13/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1770860124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | 036126664 (Illinois) | Primary |
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