Organization
BLUESTONE CAPITAL GROUP INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
OTABEK FAYZIYEV (OWNER / PRESIDENT)
(847) 696-9115
Entity
Organization
Contact information
Practice address
350 S NORTHWEST HWY, SUITE 300, PARK RIDGE, IL 60068-4216
(847) 696-9115
Mailing address
350 S NORTHWEST HWY, SUITE 300, PARK RIDGE, IL 60068-4216
(847) 696-9115
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
—
—
Other
Enumeration date
05/03/2010
Last updated
05/03/2010
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