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1386012482
SAMUEL LOGAN
ELK GROVE VILLAGE, IL
NPI
1386012482
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363L00000X Nurse Practitioner
(Licence: IL 277000181)
Enumeration Date
2015-09-04
Last Update Date
2020-08-12
Business Address
SAMUEL LOGAN APN
800 BIESTERFIELD RD
ELK GROVE VILLAGE, IL 60007-3361
Phone number: 847-690-1858
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Mailing Address
SAMUEL LOGAN APN
800 BIESTERFIELD RD
ELK GROVE VILLAGE, IL 60007-3361
Phone number: 847-690-1858
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