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Organization
DR.VASANWALA LLC
Active
Organization
DR.VASANWALA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SALIL R VASANWALA M.D. (DIRECTOR)
(815) 936-9440
Entity
Organization
Contact information
Practice address
19 HERITAGE DR, STE104, BOURBONNAIS, IL 60914-1369
(815) 936-9440
Mailing address
19 HERITAGE DR, STE104, BOURBONNAIS, IL 60914-1369
(815) 936-9440
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
NULL
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
04/24/2007
Last updated
12/08/2009
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