Organization
MIDWEST VASCULAR INSTITUTE OF ILLINOIS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMIR MOTARJEME M.D. (MEDICAL DIRECTOR)
(630) 963-0660
Entity
Organization
Contact information
Practice address
3825 HIGHLAND AVE, SUITE 306, DOWNERS GROVE, IL 60515-1552
(630) 963-0660
(630) 963-8348
Mailing address
PO BOX 297, DOWNERS GROVE, IL 60515-0297
(630) 963-0660
(630) 963-8348
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036041533
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036041533
—
IL
Enumeration date
09/27/2007
Last updated
06/27/2010
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