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General NPI Number Information
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NPI Number | 1831469410
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Entity Type | Organization
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Legal Business Name | SYMPHONY MEDICAL GROUP PC
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Dates
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Enumeration Date | 01/12/2012
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Last Update Date | 07/11/2012
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Provider Practice Location Address
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Address Line | 327 GUNDERSEN DR STE C
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City | CAROL STREAM
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State | IL
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Zip | 60188-2453
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Country | US
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Telephone | 630-668-2416
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Fax |
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Provider Business Mailing Address
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Address Line | 327 GUNDERSEN DR STE C
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City | CAROL STREAM
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State | IL
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Zip | 60188-2453
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Country | US
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Telephone | 630-668-2416
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STASIA EILEEN KAHN
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Credential | MD
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Telephone | 630-668-2416
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 060.010675
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License Number State | IL
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