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Organization

MEDICAL NUTRITIONAL THERAPY

Active
Organization subpart
No

Provider details

NPI number
Authorized official
EMILIYA SUBEV (DIETITIAN)
(224) 806-5511
Entity
Organization

Contact information

Practice address
3633 W LAKE AVE STE 406, GLENVIEW, IL 60026-5804
(224) 806-5511
Mailing address
3633 W LAKE AVE STE 406, GLENVIEW, IL 60026-5804
(224) 806-5511

Taxonomy

Speciality
Code
Description
License number
State
261QH0100X
Health Service Clinic/Center
Primary

Other

Enumeration date
10/01/2019
Last updated
10/01/2019
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