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General NPI Number Information
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NPI Number | 1437164845
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Entity Type | Organization
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Legal Business Name | BROOKSIDE ASSOCIATES, LTD.
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 06/23/2008
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Provider Practice Location Address
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Address Line | 213 6TH ST
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City | WILMETTE
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State | IL
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Zip | 60091-3437
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Country | US
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Telephone | 847-853-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 213 6TH ST
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City | WILMETTE
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State | IL
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Zip | 60091-3437
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Country | US
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Telephone | 847-853-1500
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MICHAEL JOHN HUGHEY
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Credential | M.D.
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Telephone | 847-446-1100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State |
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