Healthcare Provider Details

I. General information

NPI: 1669586079
Provider Name (Legal Business Name): SERGEY FURMANOV MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

150 N RIVER RD STE 270
DES PLAINES IL
60016-1272
US

IV. Provider business mailing address

150 N RIVER RD STE 270
DES PLAINES IL
60016-1272
US

V. Phone/Fax

Practice location:
  • Phone: 847-298-8470
  • Fax: 847-298-6819
Mailing address:
  • Phone: 847-298-8470
  • Fax: 847-298-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: