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1063944205
EDGAR DAVILA
BURR RIDGE, IL
NPI
1063944205
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207R00000X Internal Medicine
(Licence: IL 125.071499)
Enumeration Date
2017-03-28
Last Update Date
2017-07-03
Business Address
-- EDGAR DAVILA
124 79TH ST
BURR RIDGE, IL 60527-5958
Phone number: 773-641-2037
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Mailing Address
-- EDGAR DAVILA
124 79TH ST
BURR RIDGE, IL 60527-5958
Phone number: 773-641-2037
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