Organization
SUSAN C BALBERDE, MD,SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN BALVERDE M.D. (PRESIDENT)
(773) 525-4511
Entity
Organization
Contact information
Practice address
8330 GRAND AVE, RIVER GROVE, IL 60171-1435
(708) 681-3000
Mailing address
5524 N PIONEER AVE, CHICAGO, IL 60656-1546
(773) 525-4511
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036046845
IL
Other
Enumeration date
11/12/2013
Last updated
11/12/2013
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