Ivan Ivanov

NPI #1487281176 in River Forest, Illinois

Provider Information

NPI Number: 1487281176
Entity Type: Individual
Name: Ivan Ivanov
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Mar 24, 2020
Last Updated: Mar 24, 2020

Practice Location

Address: 1516 FRANKLIN AVE
City: River Forest
State: Illinois
ZIP Code: 60305-1043
Phone: (773) 909-3741

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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