NPI Provider: 1174529614
Contact Name: lubowsky david
Position: bookkeeper
Phone: (847) 679-7484
Sovereign Healthcare Information:
Sovereign Healthcare organization have npi 1174529614, taxonomy code is 313M00000X with license number is 14496R in . This Business address located in 6500 n hamlin, lincolnwood, IL 60712 Illinois.
Practice Location
Address: 6159 N Kenmore Ave, Chicago, IL 60660
Phone: (773) 761-9050
Business Location
Address: 6500 n hamlin, lincolnwood, IL 60712
Phone: (847) 679-7484
Fax: (847) 679-7494
Taxonomy
Taxonomy Code: 313M00000X
License Number: 14496R
License Number of State: IL
Primary Taxonomy Switch: Y
Enumeration Date: 6/21/2005
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