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Organization

GRAND VEIN SPECIALISTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JAVIER FLORES (OWNER)
(773) 942-6141
Entity
Organization

Contact information

Practice address
4952 W IRVING PARK RD STE 300, CHICAGO, IL 60641-2693
(773) 942-6141
(866) 707-2267
Mailing address
4952 W IRVING PARK RD STE 300, CHICAGO, IL 60641-2693
(773) 942-6141
(866) 707-2267

Taxonomy

Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
036-116087
IL
207Q00000X
Family Medicine Physician
Primary
036-116087
IL

Other

Enumeration date
02/06/2012
Last updated
02/09/2021
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