Organization
ADVANCED OCCUPATIONAL MEDICINE SPECIALISTS
Active
Organization
ADVANCED OCCUPATIONAL MEDICINE SPECIALISTS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RAJEEV KHANNA MD (MEDICAL DIRECTOR)
(708) 493-0299
Entity
Organization
Contact information
Practice address
2615 HARRISON ST, BELLWOOD, IL 60104
(708) 493-0299
Mailing address
2615 HARRISON ST, BELLWOOD, IL 60104
Taxonomy
Speciality
Code
Description
License number
State
207RS0010X
Sports Medicine (Internal Medicine) Physician
Primary
085004020
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1457344657
NPI
IL
Enumeration date
12/31/2012
Last updated
12/31/2012
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