Organization
BROOKSIDE ADVANCED CLINIC FOR PAIN,INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DANIEL W BORVAN (PRESIDENT)
(815) 469-9750
Entity
Organization
Contact information
Practice address
21120 WASHINGTON PKWY, FRANKFORT, IL 60423-3112
(815) 469-9750
(815) 469-9752
Mailing address
21120 WASHINGTON PKWY, FRANKFORT, IL 60423-3112
(815) 469-9750
(815) 469-9752
Taxonomy
Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
209003563
IL
Other
Enumeration date
01/14/2009
Last updated
01/14/2009
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