MEDICARE: NORTHSHORE CENTER FOR GASTROENTEROLOGY, SC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0100X	Gastroenterology Physician

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	110136967	OTHER	IL	MEDICARE RAILROAD
2	100016697	OTHER	IL	MEDICARE RAILRAOD
3	P00214785	OTHER	IL	MEDICARE RAILROAD

General Provider Information

NPI Number	:	1003954827
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTHSHORE CENTER FOR GASTROENTEROLOGY, SC

Provider Business Mailing Address
First Line	:	1880 W WINCHESTER RD
Second Line	:	SUITE 201
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-5341
Country	:	US
Telephone Number	:	847-247-0187
Fax Number	:	847-247-0487

Provider Business Practice Location Address
First Line	:	1880 W WINCHESTER RD
Second Line	:	SUITE 201
City	:	LIBERTYVILLE
State	:	IL
Zip	:	60048-5341
Country	:	US
Telephone Number	:	847-247-0187
Fax Number	:	847-247-0487

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. ARKAN I ALRASHID
Credential	:	MD
Telephone Number	:	847-247-0187

Provider Enumeration Date	:	02/02/2007
Last Update Date	:	06/06/2012

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Directions to “NORTHSHORE CENTER FOR GASTROENTEROLOGY, SC ” Practice Location

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