| Passport Enterprises Llc | |
|
250 Center Dr Ste 202 Vernon Hills IL 60061-1582 | |
| (847) 816-3434 | |
| Not Available |
| Full Name | Passport Enterprises Llc |
|---|---|
| Speciality | Clinic/center |
| Location | 250 Center Dr Ste 202, Vernon Hills, Illinois |
| Authorized Official Name and Position | Elizabeth Capron (BUSINESS MANAGER) |
| Authorized Official Contact | 8176813775 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Passport Enterprises Llc 250 Center Dr Ste 202 Vernon Hills IL 60061-1582 Ph: (847) 816-3434 | Passport Enterprises Llc 250 Center Dr Ste 202 Vernon Hills IL 60061-1582 Ph: (847) 816-3434 |
| NPI Number | 1093978603 |
|---|---|
| Provider Enumeration Date | 07/03/2008 |
| Last Update Date | 07/03/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1093978603 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 036099609 (Illinois) | Primary |
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Passport Health Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 250 Center Dr Ste 202, Vernon Hills, IL 60061 Phone: 847-816-3434 Fax: 847-816-6363 |