Organization
MAVENA CHICAGO CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JERRI MCGINNIS (VICE PRESIDENT)
(847) 298-9400
Entity
Organization
Contact information
Practice address
1455 E GOLF RD STE 120, DES PLAINES, IL 60016-1253
(847) 298-9400
(847) 298-7660
Mailing address
500 N MICHIGAN AVE STE 300, CHICAGO, IL 60611-3775
(847) 298-9400
(847) 298-7660
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/17/2006
Last updated
08/22/2020
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