Individual
DMITRIY IGOREVICH GUBAREV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
4555 HARRISON ST, YORKVILLE, IL 60560-6027
(630) 649-2781
Mailing address
4555 HARRISON ST, YORKVILLE, IL 60560-6027
(630) 649-2781
Taxonomy
Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
Primary
041500862
IL
Other
Enumeration date
06/29/2024
Last updated
06/29/2024
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