Individual
ILAN SHAHAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2369 CHECKER RD, LONG GROVE, IL 60047-5133
(847) 769-4441
Mailing address
2369 CHECKER RD, LONG GROVE, IL 60047-5133
(847) 769-4441
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
TGC110359
IL
Other
Enumeration date
08/20/2024
Last updated
08/20/2024
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