Individual
IVAILO DICHEV DIMOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
77 BLACKHAWK RD, HIGHLAND PARK, IL 60035-5227
(847) 208-0532
Mailing address
77 BLACKHAWK RD, HIGHLAND PARK, IL 60035-5227
(847) 208-0532
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
036101550
IL
207L00000X
Anesthesiology Physician
A76262
CA
Other
Enumeration date
09/22/2006
Last updated
03/02/2015
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