Alfred Ivanov

NPI #1235282690 in Willowbrook, Illinois

Provider Information

NPI Number: 1235282690
Entity Type: Individual
Name: Alfred Ivanov
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Jan 19, 2007
Last Updated: Mar 17, 2025

Practice Location

Address: 7440 TENNESSEE DR APT 206
City: Willowbrook
State: Illinois
ZIP Code: 60527-2368
Phone: (630) 544-7336

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X
Massage Therapist	225700000X	Primary

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