JOLIET CBOC (829)    INSTITUTION (4)

Name Value
NAME JOLIET CBOC
STATE ILLINOIS
STREET ADDR. 1 1201 EAGLE STREET
CITY JOLIET
ZIP 60432-2031
OFFICIAL VA NAME JOLIET CBOC (578GA)
STATUS National
ASSOCIATIONS
BILLING FACILITY NAME JOLIET VA CBOC
ST. ADDR. 1 (MAILING) 1201 EAGLE STREET
CITY (MAILING) JOLIET
STATE (MAILING) ILLINOIS
ZIP (MAILING) 60432-2031
EFFECTIVE DATE/TIME
  • 2007-01-08 00:00:00
    STATUS:   ACTIVE
    NPI:   1104872761
TAXONOMY CODE
LOCATION TIMEZONE CENTRAL
COUNTRY USA
AGENCY CODE VA
POINTER TO AGENCY VA
STATION NUMBER 578GA
IDENTIFIER
  • CODING SYSTEM:   NPI
    ID:   1104872761
  • CODING SYSTEM:   VASTANUM
    ID:   578GA
  • CODING SYSTEM:   CLIA
    ID:   14D0988058