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General NPI Number Information
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NPI Number | 1487799722
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Entity Type | Organization
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Legal Business Name | SOUTHWEST CENTER FOR GASTROENTEROLOGY
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 12/23/2008
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Provider Practice Location Address
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Address Line | 9921 SOUTHWEST HIGHWAY
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-425-9456
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Fax | 708-425-9468
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Provider Business Mailing Address
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Address Line | 9921 SOUTHWEST HIGHWAY
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City | OAK LAWN
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State | IL
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Zip | 60453
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Country | US
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Telephone | 708-425-9456
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Fax | 708-425-9468
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Authorized Official
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Title or Position | CHIEF FINANCIAL OFFICER
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Name | THOMAS ARNDT
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Credential | MD
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Telephone | 708-425-9456
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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 |
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License Number State |
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