Organization
BROADWAY MEDICAL CARE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PEYMAN PAHLAVAN MD (OWNER)
(708) 345-8960
Entity
Organization
Contact information
Practice address
414 W LAKE ST, ADDISON, IL 60101-2305
(708) 345-8960
Mailing address
414 W LAKE ST, ADDISON, IL 60101-2305
(708) 345-8960
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Enumeration date
03/05/2020
Last updated
03/05/2020
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