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General NPI Number Information
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NPI Number | 1013007368
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Entity Type | Organization
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Legal Business Name | PINNACLE HEALTH SC
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Dates
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Enumeration Date | 10/14/2006
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Last Update Date | 11/28/2007
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Provider Practice Location Address
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Address Line | 9955 KARLOV AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1117
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Country | US
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Telephone | 847-677-1122
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Fax | 847-677-7382
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Provider Business Mailing Address
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Address Line | 9955 KARLOV AVE
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City | SKOKIE
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State | IL
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Zip | 60076-1117
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Country | US
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Telephone | 847-677-1122
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Fax | 847-677-7382
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Authorized Official
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Title or Position | PRESIDENT
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Name | ANSHU A RAJ
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Credential | M.D
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Telephone | 847-677-1122
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | IL
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