Organization
YOUR MEDICOS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. NIKITA TAVKAR (MANAGER)
(847) 850-5882
Entity
Organization
Contact information
Practice address
1300 BUSCH PKWY, BUFFALO GROVE, IL 60089-4505
(847) 850-5882
(847) 850-5892
Mailing address
1300 BUSCH PKWY, BUFFALO GROVE, IL 60089-4505
(847) 850-5882
(847) 850-5892
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
038010683
IL
261QA1903X
Ambulatory Surgical Clinic/Center
036074991
IL
261QM1300X
Multi-Specialty Clinic/Center
036074991
IL
261QP2000X
Physical Therapy Clinic/Center
036074991
IL
261QP2300X
Primary Care Clinic/Center
Primary
036074991
IL
Other
Enumeration date
07/23/2010
Last updated
04/03/2015
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