MEDICARE: HEAD & NECK ASSOCIATES, SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist		IL

General Provider Information

NPI Number	:	1407803174
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HEAD & NECK ASSOCIATES, SC

Provider Business Mailing Address
First Line	:	1400 E GOLF RD
Second Line	:	SUITE 121
City	:	DES PLAINES
State	:	IL
Zip	:	60016-1236
Country	:	US
Telephone Number	:	847-827-2300
Fax Number	:	847-827-2392

Provider Business Practice Location Address
First Line	:	1400 E GOLF RD
Second Line	:	SUITE 121
City	:	DES PLAINES
State	:	IL
Zip	:	60016-1236
Country	:	US
Telephone Number	:	847-827-2300
Fax Number	:	847-827-2392

Authorized Official
Title or Position	:	DIRECTOR
Name	:	ANDREW J LERRICK
Credential	:	M.D.
Telephone Number	:	847-827-2300

Provider Enumeration Date	:	05/28/2006
Last Update Date	:	06/24/2009

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