NPI 1104291434

Santos Natural Health Center

Organisation Exclusive Provider Organization Berwyn, IL

Practice location

Address: 6905 Cermak Rd STE B, Berwyn, IL 60402-2175
Phone: (708) 317-4240

Authorised official

Name: Anas Husni Khalifeh
Title: Co-Owner
Phone: (630) 670-8351

Registered specialties

Exclusive Provider Organization Primary

Managed Care Organizations Taxonomy 302F00000X Licence 198001280 (IL)

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Registry record

NPI: 1104291434
Entity type: Organization
NPI issued: 11 Dec 2015
Record last updated: 11 Dec 2015

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.