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General NPI Number Information
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NPI Number | 1164811949
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Entity Type | Organization
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Legal Business Name | NORTH SHORE HEALTH CENTER
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Dates
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Enumeration Date | 01/15/2015
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Last Update Date | 01/15/2015
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Provider Practice Location Address
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Address Line | 5250 OLD ORCHARD RD SUITE 300
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City | SKOKIE
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State | IL
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Zip | 60077-4460
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Country | US
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Telephone | 847-253-0557
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Fax |
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Provider Business Mailing Address
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Address Line | 5250 OLD ORCHARD RD SUITE 300
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City | SKOKIE
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State | IL
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Zip | 60077-4460
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Country | US
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Telephone | 847-253-0557
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA KRASZYNSKA
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Credential | MD
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Telephone | 847-253-0557
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 036063993
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License Number State | IL
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