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General NPI Number Information
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NPI Number | 1023214426
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Entity Type | Organization
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Legal Business Name | OTOLARYNGOLOGY ASSOCIATES SC
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Dates
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Enumeration Date | 06/22/2007
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 680 N LAKE SHORE DR APT 1525
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City | CHICAGO
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State | IL
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Zip | 60611-3478
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Country | US
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Telephone | 312-944-3627
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Fax | 312-944-6420
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Provider Business Mailing Address
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Address Line | 680 N LAKE SHORE DR APT 1525
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City | CHICAGO
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State | IL
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Zip | 60611-3478
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Country | US
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Telephone | 312-944-3627
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Fax | 312-944-6420
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | REGINA M PROPOGGIO
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Credential |
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Telephone | 312-944-3627
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number |
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License Number State |
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