Individual
LINUS EMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2535 S KING DR, CHICAGO, IL 60616-4746
(312) 842-7117
Mailing address
29373 NETWORK PL, CHICAGO, IL 60673-1293
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
036-087190
IL
Other
Enumeration date
07/09/2006
Last updated
02/19/2025
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