Provider Demographics
NPI:1053718445
Name:COMPANIAN ANIMAL SPECIALTY AND EMERGENCY HOSPITAL
Entity type:Organization
Organization Name:COMPANIAN ANIMAL SPECIALTY AND EMERGENCY HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VETERINARIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ALICIA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:RAGNI
Authorized Official - Suffix:
Authorized Official - Credentials:DVM
Authorized Official - Phone:815-479-9119
Mailing Address - Street 1:1095 PINGREE RD
Mailing Address - Street 2:SUITE 120
Mailing Address - City:CRYSTAL LAKE
Mailing Address - State:IL
Mailing Address - Zip Code:60014-1725
Mailing Address - Country:US
Mailing Address - Phone:815-479-9119
Mailing Address - Fax:847-854-9119
Practice Address - Street 1:1095 PINGREE RD
Practice Address - Street 2:SUITE 120
Practice Address - City:CRYSTAL LAKE
Practice Address - State:IL
Practice Address - Zip Code:60014-1725
Practice Address - Country:US
Practice Address - Phone:815-479-9119
Practice Address - Fax:847-854-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-12-01
Last Update Date:2014-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL090-006289174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174M00000XOther Service ProvidersVeterinarianGroup - Multi-Specialty