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1902464647
SAMUEL J TRAVERSO
LA GRANGE, IL
NPI
1902464647
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: IL 125074102)
Enumeration Date
2019-05-29
Last Update Date
2019-06-11
Business Address
SAMUEL J TRAVERSO DO
1325 COMMUNITY MEMORIAL DR
LA GRANGE, IL 60525-2659
Phone number: 708-245-8900
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Mailing Address
SAMUEL J TRAVERSO DO
1325 COMMUNITY MEMORIAL DRIVE
LA GRANGE, IL 60525-2659
Phone number: 708-245-8900
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