| Milt88 Inc | |
|
6501 95th St Sears Optical Chicago Ridge IL 60415-2632 | |
| (708) 499-4676 | |
| Not Available |
| Full Name | Milt88 Inc |
|---|---|
| Speciality | Clinic/center |
| Location | 6501 95th St, Chicago Ridge, Illinois |
| Authorized Official Name and Position | Michael Tabernacki (PRESIDENT) |
| Authorized Official Contact | 7086012688 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Milt88 Inc 3946 Johnson Ave Western Springs IL 60558-1139 Ph: () - | Milt88 Inc 6501 95th St Sears Optical Chicago Ridge IL 60415-2632 Ph: (708) 499-4676 |
| NPI Number | 1245781269 |
|---|---|
| Provider Enumeration Date | 10/14/2016 |
| Last Update Date | 10/14/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245781269 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 046-008140 (Illinois) | Primary |
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