Organization
INTEGRATIVE MED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J LACAVA M.D. (PARTNER)
(847) 695-6262
Entity
Organization
Contact information
Practice address
1750 N RANDALL RD, SUITE 250, ELGIN, IL 60123-7900
(847) 695-6262
(847) 695-6348
Mailing address
1750 N RANDALL RD, SUITE 250, ELGIN, IL 60123-7900
(847) 695-6262
(847) 695-6348
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
036065641
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004532289
BLUE CROSS/BLUE SHIELD OF ILLINOIS
IL
Enumeration date
05/07/2010
Last updated
05/07/2010
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