Organization
MEDINTEL PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NELLY KVIRIKADZE MD (PRESIDENT)
(773) 750-9696
Entity
Organization
Contact information
Practice address
532 LOCKARD LN, HIGHWOOD, IL 60040-1223
(773) 750-9696
(224) 848-6296
Mailing address
532 LOCKARD LN, HIGHWOOD, IL 60040-1223
(773) 750-9696
(224) 848-6296
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
036114198
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036114198
—
IL
Enumeration date
07/07/2014
Last updated
07/07/2014
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