Organization
ILLINOIS ADULT HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ILYA I FISHMAN MD (OWNER/PHYSICIAN)
(718) 644-6778
Entity
Organization
Contact information
Practice address
800 BIESTERFIELD RD, SUITE 3007, ELK GROVE VILLAGE, IL 60007-3361
(847) 290-6513
(847) 290-8505
Mailing address
800 BIESTERFIELD RD, SUITE 3007, ELK GROVE VILLAGE, IL 60007-3361
(847) 290-6513
(847) 290-8505
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036118688
IL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
036118688
IL
Other
Enumeration date
04/05/2016
Last updated
04/05/2016
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