Organization
VEIN CLINICS OF ILLINOIS S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CAROLINE NOVAK MD (OWNER)
(347) 405-8160
Entity
Organization
Contact information
Practice address
1212 N LA SALLE DR STE 100, CHICAGO, IL 60610-2379
(347) 405-8160
(347) 405-8161
Mailing address
244 MADISON AVE # 1120, NEW YORK, NY 10016-2817
(347) 405-8160
(347) 405-8161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
042.620961
STATE LICENSE NUMBER
IL
Enumeration date
11/07/2019
Last updated
11/14/2019
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