Individual
KSENIA SAMVEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1425 N HUNT CLUB RD STE 100, GURNEE, IL 60031-2632
(847) 548-2200
(847) 548-2865
Mailing address
1425 N HUNT CLUB RD STE 100, GURNEE, IL 60031-2632
(847) 548-2200
(847) 548-2865
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085.004974
IL
363AM0700X
Medical Physician Assistant
PA08386
TX
Other
Enumeration date
08/02/2013
Last updated
03/21/2024
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