Organization
ASPEN MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALEXANDER POTERMIN (MEMBER)
(847) 354-8086
Entity
Organization
Contact information
Practice address
1120 THOMPSON BLVD, BUFFALO GROVE, IL 60089-1021
(847) 354-8086
Mailing address
1120 THOMPSON BLVD, BUFFALO GROVE, IL 60089-1021
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36104917
IL
Other
Enumeration date
02/01/2008
Last updated
02/02/2015
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