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General NPI Number Information
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NPI Number | 1538204961
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Entity Type | Organization
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Legal Business Name | PALATINE INTERNAL MEDICINE SC
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 855 E PALATINE ROAD SUITE 250
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City | PALATINE
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State | IL
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Zip | 60074
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Country | US
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Telephone | 847-359-3363
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Fax | 847-359-3904
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Provider Business Mailing Address
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Address Line | 855 E PALATINE ROAD SUITE 250
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City | PALATINE
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State | IL
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Zip | 60074
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Country | US
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Telephone | 847-359-3363
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Fax | 847-359-3904
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Authorized Official
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Title or Position | CEO PRESIDENT
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Name | VICTOR A LESNIAUSKAS
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Credential | MD
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Telephone | 847-359-3363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State | IL
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