Individual
YEVGENIA GAVRIELOV
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
631 CONCORD WAY, PROSPECT HEIGHTS, IL 60070-3429
(224) 639-5558
Mailing address
631 CONCORD WAY, PROSPECT HEIGHTS, IL 60070-3429
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
2474029
IL
Other
Enumeration date
08/25/2014
Last updated
08/25/2014
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