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General NPI Number Information
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NPI Number | 1437329455
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Entity Type | Organization
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Legal Business Name | NEIL D. POLLOCK, M.D. S.C.
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Dates
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Enumeration Date | 03/05/2008
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Last Update Date | 06/25/2008
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Provider Practice Location Address
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Address Line | 890 GARFIELD AVE STE 106
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3100
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Country | US
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Telephone | 847-367-7470
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Fax | 847-367-4901
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Provider Business Mailing Address
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Address Line | 890 GARFIELD AVE STE 106
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City | LIBERTYVILLE
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State | IL
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Zip | 60048-3100
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Country | US
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Telephone | 847-367-7470
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Fax | 847-367-4901
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Authorized Official
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Title or Position | PRESIDENT
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Name | NEIL D. POLLOCK
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Credential | M.D., S.C.
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Telephone | 847-367-7470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 036044374
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License Number State | IL
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