Organization
CAMMI, LLC
Active
Other names
LifeForce Medical Institute
Organization subpart
No
Provider details
NPI number
Authorized official
MARK ROSENBLOOM MD, MBA, FAAEM (CHIEF MEDICAL OFFICER)
(773) 649-4154
Entity
Organization
Contact information
Practice address
1840 OAK AVE, SUITE 125, EVANSTON, IL 60201-3642
(773) 649-4154
(773) 453-3202
Mailing address
1840 OAK AVE, SUITE 125, EVANSTON, IL 60201-3642
(773) 649-4154
(773) 453-3202
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
Primary
036.085053
IL
Other
Enumeration date
03/16/2012
Last updated
03/16/2012
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