Organization
AMAR L DAVE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMAR LAL DAVE MD (MD OWNER)
(815) 434-2115
Entity
Organization
Contact information
Practice address
1209 STARFIRE DR, SUITE 1, OTTAWA, IL 61350-1614
(815) 434-2115
Mailing address
1209 STARFIRE DR, SUITE 1, OTTAWA, IL 61350-1614
(815) 434-2115
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
036057338
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036057338
—
IL
Enumeration date
12/29/2016
Last updated
12/29/2016
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