Individual
MICHAEL GBOGBO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5273 WAKEFIELD LN, LONG GROVE, IL 60047-5221
(847) 722-3559
Mailing address
PO BOX 4832, BUFFALO GROVE, IL 60089-4832
(847) 722-3559
Taxonomy
Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
238.000770
IL
Other
Enumeration date
02/15/2024
Last updated
02/15/2024
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