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Individual

ALFRED IVANOV

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
7850 S QUINCY ST, WILLOWBROOK, IL 60527-5534
(630) 991-0157
Mailing address
7521 COUNTRY LN, DARIEN, IL 60561-4622
(630) 991-0157

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
227006262
IL
225700000X
Massage Therapist
Primary
227006262
IL

Other

Enumeration date
01/19/2007
Last updated
04/26/2026
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