Icor Llc | |
5926 N Santa Monica Blvd Milwaukee WI 53217-4618 | |
(773) 715-8034 | |
Not Available |
Full Name | Icor Llc |
---|---|
Speciality | Internal Medicine |
Location | 5926 N Santa Monica Blvd, Milwaukee, Wisconsin |
Authorized Official Name and Position | Ludmil Lazarov (OWNER) |
Authorized Official Contact | 7737158034 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
---|---|
Icor Llc 5926 N Santa Monica Blvd Milwaukee WI 53217-4618 Ph: () - | Icor Llc 5926 N Santa Monica Blvd Milwaukee WI 53217-4618 Ph: (773) 715-8034 |
NPI Number | 1649863986 |
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Provider Enumeration Date | 02/18/2021 |
Last Update Date | 04/15/2021 |
Identifier | Type | State | Issuer |
---|---|---|---|
1649863986 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
207R00000X | Internal Medicine | (* (Not Available)) | Primary |
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