Organization
STANLEY BALOWAS M.D.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STANLEY BIALOWAS M.D. (PRESIDENT)
(773) 283-7535
Entity
Organization
Contact information
Practice address
3902 W DIVERSEY AVE, CHICAGO, IL 60647-1021
(773) 283-7535
Mailing address
3902 W DIVERSEY AVE, CHICAGO, IL 60647-1021
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
36071723
IL
Other
Enumeration date
02/14/2016
Last updated
02/14/2016
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