Individual
DR. AMMAR Y DIVAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
245 S GARY AVE STE 100, BLOOMINGDALE, IL 60108-2200
(630) 933-4550
(630) 933-2200
Mailing address
245 S GARY AVE STE 100, BLOOMINGDALE, IL 60108-2200
(630) 933-4550
(630) 933-2200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
0101247908
VA
207L00000X
Anesthesiology Physician
036123274
IL
207L00000X
Anesthesiology Physician
068143
GA
207L00000X
Anesthesiology Physician
D71131
MD
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
036123274
IL
Other
Enumeration date
07/20/2010
Last updated
07/16/2024
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