Organization
DATTA SAMBARE MD SC
Active
Parent organization
DATTA.SAMBARE.MD,SC
Other names
North Forest Medical Associates
Organization subpart
Yes
Provider details
NPI number
Legal business name
DATTA.SAMBARE.MD,SC
Authorized official
DR. DATTA SAMBARE M.D. (MANAGER)
(708) 613-4738
Entity
Organization
Contact information
Practice address
6957 NORTH AVE, OAK PARK, IL 60302-1068
(708) 613-4738
Mailing address
PO BOX 215, WESTMONT, IL 60559-0215
(708) 613-4738
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036-129147
IL
Other
Enumeration date
11/14/2013
Last updated
07/07/2015
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