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General NPI Number Information
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NPI Number | 1023139136
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Entity Type | Organization
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Legal Business Name | NORTH SHORE ASSOCIATES IN GYNECOLOGY AND OBSTETRICS, S.C.
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Dates
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Enumeration Date | 04/03/2007
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Last Update Date | 09/17/2009
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Provider Practice Location Address
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Address Line | 2500 RIDGE AVE SUITE 301
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City | EVANSTON
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State | IL
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Zip | 60201-2455
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Country | US
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Telephone | 847-475-1224
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Fax | 847-475-0150
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Provider Business Mailing Address
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Address Line | 2500 RIDGE AVE SUITE 301
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City | EVANSTON
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State | IL
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Zip | 60201-2455
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Country | US
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Telephone | 847-475-1224
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Fax | 847-475-0150
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HANI JACOB SALEH
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Credential | M.D.
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Telephone | 847-475-1224
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 042-006555
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License Number State | IL
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