Facts
- Status
- A
- Type
- Organization
- Enumeration date
- 2009-09-16
- Last updated
- 2009-09-16
Specialties
Licenses
- License IL
- 036114318
Location
- Practice location
- 659 VERNON AVE
- City
- GLENCOE IL
- Postal code
- 600221641
- Phone
- 847-242-0700
Organization contact
- Name
- KUDUS AKINDE
- Title
- Owner
- Phone
- 8472420700
Medicare
- PECOS
- No PECOS enrollment row matched this NPI.
LEIE
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Removal request
Public data from NPPES and CMS. Not a credentialing determination.