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NPI Code Detail

MEDICARE: DAVID EDWARD KVARNBERG M.D.

MEDICARE:   DAVID EDWARD KVARNBERG  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0400XNeurology Physician036.125485IL

General Provider Information

NPI Number : 1659367365
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID EDWARD KVARNBERG M.D.
Provider Business Mailing Address
First Line : 501 FERDINAND AVE
Second Line :
City : FOREST PARK
State : IL
Zip : 60130-1803
Country : US
Telephone Number : 708-408-3632
Fax Number :
Provider Business Practice Location Address
First Line : 5000 S 5TH AVE
Second Line : DEPTARTMENT OF NEUROLOGY, EDWARD HINES, JR. VA HOSPITAL
City : HINES
State : IL
Zip : 60141-3030
Country : US
Telephone Number : 708-202-8387
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/27/2005
Last Update Date : 07/29/2012

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Directions to “ DAVID EDWARD KVARNBERG M.D.” Practice Location

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