Provider Demographics
NPI:1497593040
Name:MAVIN WOUND PHYSICIANS LLC
Entity type:Organization
Organization Name:MAVIN WOUND PHYSICIANS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SABRINA
Authorized Official - Middle Name:ANTONINA
Authorized Official - Last Name:INDYK
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-287-6497
Mailing Address - Street 1:2556 INDIAN RIDGE CT
Mailing Address - Street 2:
Mailing Address - City:GLENVIEW
Mailing Address - State:IL
Mailing Address - Zip Code:60026-2060
Mailing Address - Country:US
Mailing Address - Phone:847-287-6497
Mailing Address - Fax:
Practice Address - Street 1:1701 E WOODFIELD RD STE 215
Practice Address - Street 2:
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60173-5127
Practice Address - Country:US
Practice Address - Phone:847-287-6497
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-17
Last Update Date:2025-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty