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General NPI Number Information
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NPI Number | 1811122567
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Entity Type | Organization
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Legal Business Name | HARWIN HEALTHCARE & DIAGNOSTICS SC
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Dates
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Enumeration Date | 05/26/2009
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 15030 S RAVINIA AVE STE 38
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City | ORLAND PARK
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State | IL
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Zip | 60462-3258
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Country | US
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Telephone | 708-460-4621
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Fax | 708-460-4627
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Provider Business Mailing Address
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Address Line | 15030 S. RAVINIA AVE STE 38
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City | ORLAND PARK
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State | IL
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Zip | 60562
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Country | US
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Telephone | 708-460-4621
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Fax | 708-460-4627
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Authorized Official
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Title or Position | CMM
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Name | LANA MOSHKOVICH
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Credential | CMM, CPC, CEMC
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Telephone | 847-904-7500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number |
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License Number State |
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