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Individual

DR. JOEL LEON BORGEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1969 N LINCOLN AVE, APT G, CHICAGO, IL 60614-5403
(773) 899-0204
Mailing address
1969 N LINCOLN AVE, APT G, CHICAGO, IL 60614-5403
(773) 899-0204

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
125051558
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
D70300
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
032652600
MD
Enumeration date
07/25/2008
Last updated
07/15/2010
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