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Organization
MACUMBER MEDICAL LTD
Active
Organization
MACUMBER MEDICAL LTD
Active
Other names
Advanced Vein Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MARK MACUMBER MD (OWNER)
(773) 220-0376
Entity
Organization
Contact information
Practice address
3114 W IRVING PARK RD STE 1W, CHICAGO, IL 60618-3435
(833) 388-7669
(833) 388-7669
Mailing address
3114 W IRVING PARK RD STE 1W, CHICAGO, IL 60618-3435
(833) 388-7669
(833) 388-7669
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
Primary
—
NULL
202K00000X
Phlebology Physician
Primary
—
—
261QM2500X
Medical Specialty Clinic/Center
—
NULL
Other
Enumeration date
04/01/2020
Last updated
11/28/2022
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