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General NPI Number Information
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NPI Number | 1104238799
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Entity Type | Organization
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Legal Business Name | INVERNESS HEALTHCARE ASSOCIATES INC
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Dates
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Enumeration Date | 05/30/2014
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Last Update Date | 05/30/2014
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Provider Practice Location Address
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Address Line | 201 E PARK ST UNIT C
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City | MUNDELEIN
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State | IL
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Zip | 60060-1973
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Country | US
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Telephone | 224-475-0820
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Fax | 224-475-0821
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Provider Business Mailing Address
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Address Line | 1 MESA DR
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City | SOUTH BARRINGTON
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State | IL
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Zip | 60010-1094
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Country | US
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Telephone | 847-409-9148
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. GURU SHANKAR
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Credential | MD
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Telephone | 847-409-9148
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number |
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License Number State |
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