Organization
KM SURGICAL, P.C.
Active
Other names
Vasectomy Clinics of Chicago, KM Surgical, S.C., Kiumars Mostowfi, M.D., S.C.
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIUMARS MOSTOWFI M.D. (PRESIDENT)
(312) 528-9068
Entity
Organization
Contact information
Practice address
505 N LAKE SHORE DR, SUITE 203, CHICAGO, IL 60611
(312) 528-9068
(312) 278-4492
Mailing address
PO BOX 669, LIBERTYVILLE, IL 60048-0669
(312) 528-9068
(312) 278-4492
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036046251
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036046251
—
IL
Enumeration date
03/26/2007
Last updated
08/15/2019
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