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Organization

TOTAL CARE MEDICAL CLINIC

Active
Other names
total care medical group
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LEONARD M SPISHAKOFF MD (PHYSICIAN)
(708) 484-9506
Entity
Organization

Contact information

Practice address
6929 OGDEN AVE, BERWYN, IL 60402-3649
(708) 484-9472
(708) 484-9473
Mailing address
6929 OGDEN AVE, BERWYN, IL 60402-3649
(708) 484-9472
(708) 484-9473

Taxonomy

Speciality
Code
Description
License number
State
207QA0401X
Addiction Medicine (Family Medicine) Physician
Primary
036091578
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
036091578
IL
Enumeration date
01/28/2008
Last updated
04/13/2011
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