Organization
GENESIS INTEGRATIVE MEDICINE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN CONROY (OWNER)
(331) 442-4132
Entity
Organization
Contact information
Practice address
1881 S RANDALL RD STE C, GENEVA, IL 60134-2532
(331) 442-4132
Mailing address
1881 S RANDALL RD STE C, GENEVA, IL 60134-2532
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
10/11/2018
Last updated
10/11/2018
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