MCHENRY CBOC (1379)    INSTITUTION (4)

Name Value
NAME MCHENRY CBOC
STATE ILLINOIS
STREET ADDR. 1 3715 MUNICIPAL DRIVE
CITY MCHENRY
ZIP 60050-5483
OFFICIAL VA NAME MCHENRY CBOC
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME HENRY VA CLINIC
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1811934722
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 556GC
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1811934722
  • CODING SYSTEM:   VASTANUM
    ID:   556GC
  • CODING SYSTEM:   CLIA
    ID:   14D1024852