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1144588039
LUIS VICTOR FERNANDEZ
GREAT LAKES, IL
NPI
1144588039
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date
2012-04-27
Last Update Date
2012-04-27
Business Address
Mr. LUIS VICTOR FERNANDEZ
2410 SAMPSON ST
GREAT LAKES, IL 60088-2942
Phone number: 847-688-2469
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Mailing Address
Mr. LUIS VICTOR FERNANDEZ
2410 SAMPSON ST. BLDG 237
GREAT LAKES, IL 60088
Phone number: 847-688-2469
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