Auf Dem Graben, Edgar

Auf Dem Graben, Edgar is an sole proprietor health care provider with primary practice located at 100 N River Rd Ste G122 , Des Plaines IL 60016-1209. He recently has only one registered license in Pharmacy Service Providers / Geriatric, which is considered as his primary health care specialty. Auf Dem Graben, Edgar can be contacted via phone (847) 581-0800.

Contact Information

Primary practice address
100 N River Rd Ste G122 Des Plaines IL 60016-1209
Phone: (847) 581-0800
Fax: (847) 410-4910
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Pharmacy Service Providers / Geriatric 1835G0303X 054-035924 Illinois

Profile Details

NPI number 1336702125
LBN Legal business name Auf Dem Graben, Edgar
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 17th, 2019
Last updated Nov 27th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1336702125 NPPES
Illinois Other 054-035924 ILLINOIS DEPARTMENT OF FINANCIAL AND PROFESSIONAL REGULATION

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