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General NPI Number Information
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NPI Number | 1982611612
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Entity Type | Organization
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Legal Business Name | LAWRENCE E GLUSKIN MD SC
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Dates
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Enumeration Date | 08/02/2006
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Last Update Date | 11/07/2007
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Provider Practice Location Address
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Address Line | 2800 N SHERIDAN RD SUITE 506
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City | CHICAGO
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State | IL
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Zip | 60657-6156
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Country | US
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Telephone | 773-404-0160
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 N SHERIDAN RD SUITE 506
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City | CHICAGO
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State | IL
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Zip | 60657-6156
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Country | US
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Telephone | 773-404-0160
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | LAWRENCE GLUSKIN
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Credential | M.D.
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Telephone | 773-248-1616
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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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