Organization
MILLENOVA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CAROLYN COULAM MD (DIRECTOR)
(312) 274-1928
Entity
Organization
Contact information
Practice address
233 E ERIE ST STE 510, CHICAGO, IL 60611-5935
(312) 274-1928
(312) 274-1879
Mailing address
5320 S RAINBOW BLVD, SUITE 300, LAS VEGAS, NV 89118-1840
(702) 794-0073
(702) 696-0554
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
—
IL
Other
Enumeration date
07/02/2007
Last updated
04/14/2008
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