Healthcare Provider Details

I. General information

NPI: 1043496433
Provider Name (Legal Business Name): A TO Z OF HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2008
Last Update Date: 02/08/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

767 PARK AVE W STE 130
HIGHLAND PARK IL
60035-2400
US

IV. Provider business mailing address

1729 N 77TH CT
ELMWOOD PARK IL
60707-4111
US

V. Phone/Fax

Practice location:
  • Phone: 847-433-1501
  • Fax:
Mailing address:
  • Phone: 708-502-3433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number036096721
License Number StateIL
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number036096721
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RS0010X
TaxonomySports Medicine (Internal Medicine) Physician
License Number036096721
License Number StateIL

VIII. Authorized Official

Name: DR. GREGORY EUGENE CROVETTI
Title or Position: PRESIDENT/CEO
Credential: M.D.
Phone: 708-502-3433