Provider Demographics
NPI:1114524022
Name:COMPREHENSIVE FAMILY MEDICAL INC
Entity type:Organization
Organization Name:COMPREHENSIVE FAMILY MEDICAL INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:STANISLAV
Authorized Official - Middle Name:
Authorized Official - Last Name:GRINBERG
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-338-4623
Mailing Address - Street 1:1375 E SCHAUMBURG RD STE 210
Mailing Address - Street 2:
Mailing Address - City:SCHAUMBURG
Mailing Address - State:IL
Mailing Address - Zip Code:60194-5156
Mailing Address - Country:US
Mailing Address - Phone:630-635-2571
Mailing Address - Fax:224-353-6694
Practice Address - Street 1:1375 E SCHAUMBURG RD STE 210
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60194-5156
Practice Address - Country:US
Practice Address - Phone:630-635-2571
Practice Address - Fax:224-353-6694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-04
Last Update Date:2024-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary CareGroup - Multi-Specialty