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General NPI Number Information
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NPI Number | 1194216408
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Entity Type | Organization
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Legal Business Name | THE NORTH SHORE IV CENTER
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Dates
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Enumeration Date | 05/22/2018
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Last Update Date | 05/22/2018
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Provider Practice Location Address
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Address Line | 200 GREEN BAY RD FL 2
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City | HIGHWOOD
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State | IL
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Zip | 60040-1703
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Country | US
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Telephone | 847-964-0326
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Fax |
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Provider Business Mailing Address
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Address Line | 200 GREEN BAY RD FL 2
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City | HIGHWOOD
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State | IL
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Zip | 60040-1703
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Country | US
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Telephone | 847-964-0326
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Fax |
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Authorized Official
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Title or Position | RECEPTION
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Name | ERICA LAFFIN
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Credential |
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Telephone | 847-964-0326
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QI0500X
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Taxonomy Name | Infusion Therapy Clinic/Center
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License Number | 042620773
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License Number State | IL
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