Occu - Sports Med Corp

NPI #1457344657 in Bellwood, Illinois

Provider Information

NPI Number: 1457344657
Entity Type: Organization
Organization Name: Occu - Sports Med Corp
Primary Specialty: Specialist
Enumeration Date: Aug 24, 2005
Last Updated: Nov 8, 2010

Practice Location

Address: 2615 HARRISON ST
City: Bellwood
State: Illinois
ZIP Code: 60104-2450
Phone: (708) 493-0199

Authorized Official

Name: CASTOLINA SOLIS, CPC
Title: BILLING MANAGER
Phone: (708) 493-0199

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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