Healthcare Provider Details

I. General information

NPI: 1063573038
Provider Name (Legal Business Name): SVETLANA SERLIN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1555 BARRINGTON RD DOCTORS BLDG ONE, SUITE 415
HOFFMAN ESTATES IL
60194-1019
US

IV. Provider business mailing address

3040 W SALT CREEK LN
ARLINGTON HTS IL
60005-1069
US

V. Phone/Fax

Practice location:
  • Phone: 847-490-4222
  • Fax: 847-490-4225
Mailing address:
  • Phone: 847-385-7323
  • Fax: 847-483-7043

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number036-106120
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: