NPI 1134650484

Disentangle LLC

Organisation Other Technician Chicago, IL

Practice location

Address: 11104 S Kedzie Ave, Chicago, IL 60655-2330
Phone: (708) 581-6487

Authorised official

Name: Jaclyn O'Connell
Title: Owner
Phone: (708) 581-6487

Registered specialties

Other Technician Primary

Technologists, Technicians & Other Technical Service Providers Taxonomy 247200000X

Other Technician, Other providers in Illinois →

Registry record

NPI: 1134650484
Entity type: Organization
NPI issued: 27 Mar 2017
Record last updated: 27 Mar 2017

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.