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General NPI Number Information
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NPI Number | 1427094077
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Entity Type | Organization
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Legal Business Name | NORTHWEST NEUROLOGY, LTD
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Dates
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Enumeration Date | 06/21/2006
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Last Update Date | 06/22/2015
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Provider Practice Location Address
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Address Line | 22285 N PEPPER RD SUITE 401
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City | LAKE BARRINGTON
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State | IL
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Zip | 60010-2538
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Country | US
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Telephone | 847-882-6604
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Fax | 847-882-6228
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Provider Business Mailing Address
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Address Line | 22285 N PEPPER RD SUITE 401
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City | LAKE BARRINGTON
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State | IL
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Zip | 60010-2538
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Country | US
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Telephone | 847-882-6604
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Fax | 847-882-6228
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SANFORD SHERMAN
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Credential | M.D.
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Telephone | 847-882-6604
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 042005757
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License Number State | IL
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