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Individual

LENA VIRASCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
D.O.

Contact information

Practice address
15 S MCHENRY RD, BUFFALO GROVE, IL 60089-6705
(847) 618-0351
(847) 618-0766
Mailing address
15 S MCHENRY RD, BUFFALO GROVE, IL 60089-6705
(847) 618-0351
(847) 618-0766

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0102204900
VA
207R00000X
Internal Medicine Physician
Primary
036148443
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036148443
STATE LICENSE
IL
Enumeration date
04/29/2014
Last updated
10/05/2021
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