Healthcare Provider Details

I. General information

NPI: 1710094602
Provider Name (Legal Business Name): GENERAL AND VASCULAR SURGERY, LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

745 FLETCHER DR STE 302
ELGIN IL
60123-4750
US

IV. Provider business mailing address

745 FLETCHER DR STE 302
ELGIN IL
60123-4750
US

V. Phone/Fax

Practice location:
  • Phone: 847-695-6600
  • Fax: 847-695-4279
Mailing address:
  • Phone: 847-695-6600
  • Fax: 847-695-4279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name: DR. RAUL L. ARON
Title or Position: PRESIDENT
Credential: M.D.
Phone: 847-695-6600