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General NPI Number Information
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NPI Number | 1245378470
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Entity Type | Organization
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Legal Business Name | EAR NOSE AND THROAT ASSOCIATES S C
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 11/19/2012
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Provider Practice Location Address
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Address Line | 7350 W COLLEGE DR STE 208
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1189
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Country | US
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Telephone | 708-361-9199
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Fax | 708-361-9299
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Provider Business Mailing Address
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Address Line | 7350 W COLLEGE DR STE 208
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City | PALOS HEIGHTS
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State | IL
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Zip | 60463-1189
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Country | US
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Telephone | 708-361-9199
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Fax | 708-361-9299
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MRS. GAIL C BARRETT
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Credential |
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Telephone | 708-361-9199
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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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