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General NPI Number Information
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NPI Number | 1265724454
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Entity Type | Organization
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Legal Business Name | ALPHA VEIN SOLUTIONS INC
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Dates
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Enumeration Date | 05/06/2011
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Last Update Date | 11/27/2013
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Provider Practice Location Address
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Address Line | 3253 HARLEM AVE SUITE 1B
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City | BERWYN
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State | IL
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Zip | 60402-2996
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Country | US
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Telephone | 708-788-3880
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Fax | 708-788-4757
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Provider Business Mailing Address
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Address Line | 3253 HARLEM AVE SUITE 1B
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City | BERWYN
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State | IL
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Zip | 60402-2996
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Country | US
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Telephone | 708-788-3880
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Fax | 708-788-4757
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WAJAHAT AKHTAR
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Credential | DC
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Telephone | 708-788-3880
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | 036098279
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License Number State | IL
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