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General NPI Number Information
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NPI Number | 1013487388
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Entity Type | Organization
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Legal Business Name | ENDOSCOPY CENTER OF THE NORTH SHORE, LLC
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Dates
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Enumeration Date | 11/29/2018
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Last Update Date | 04/10/2023
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Provider Practice Location Address
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Address Line | 1732 CENTRAL ST
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City | EVANSTON
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State | IL
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Zip | 60201-1508
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Country | US
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Telephone | 847-256-1855
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Fax | 866-375-3001
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Provider Business Mailing Address
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Address Line | 1732 CENTRAL ST
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City | EVANSTON
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State | IL
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Zip | 60201-1508
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Country | US
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Telephone | 847-256-1855
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Fax | 866-375-3001
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Authorized Official
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Title or Position | MANAGER
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Name | VLAD HALAI
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Credential |
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Telephone | 847-256-1855
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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