Healthcare Provider Details

I. General information

NPI: 1104307081
Provider Name (Legal Business Name): FILAM MEDICAL GROUP INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2018
Last Update Date: 11/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9933 LAWLER AVE STE 215
SKOKIE IL
60077-3757
US

IV. Provider business mailing address

7331 N LINCOLN AVE STE 15
LINCOLNWOOD IL
60712-1766
US

V. Phone/Fax

Practice location:
  • Phone: 847-983-8356
  • Fax:
Mailing address:
  • Phone: 847-983-8356
  • Fax: 888-909-5815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: MARIA VICTORIA LOMIBAO
Title or Position: PRESIDENT
Credential:
Phone: 224-830-3242