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General NPI Number Information
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NPI Number | 1114315397
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Entity Type | Individual
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Provider Name | DAVID EREMKINE
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Gender | Male
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Dates
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Enumeration Date | 12/22/2014
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Last Update Date | 01/12/2015
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Provider Practice Location Address
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Address Line | 738 S BUFFALO GROVE RD
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-3708
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Country | US
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Telephone | 847-520-4901
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Fax |
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Provider Business Mailing Address
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Address Line | 738 S BUFFALO GROVE RD
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City | BUFFALO GROVE
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State | IL
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Zip | 60089-3708
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Country | US
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Telephone | 847-520-4901
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 203001690
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License Number State | IL
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