Individual
SAMUEL LOGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APN
Contact information
Practice address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(847) 690-1858
Mailing address
800 BIESTERFIELD RD, ELK GROVE VILLAGE, IL 60007-3361
(847) 690-1858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
277000181
IL
Other
Enumeration date
09/04/2015
Last updated
08/12/2020
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