MEDICARE: GASTROENTEROLOGY ASSOCIATION OF OLYMPIA FIELDS

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		IL

General Provider Information

NPI Number	:	1740301423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GASTROENTEROLOGY ASSOCIATION OF OLYMPIA FIELDS

Provider Business Mailing Address
First Line	:	3030 CHICAGO RD
Second Line	:
City	:	STEGER
State	:	IL
Zip	:	60475-1055
Country	:	US
Telephone Number	:	708-756-3037
Fax Number	:	708-756-3065

Provider Business Practice Location Address
First Line	:	3030 CHICAGO RD
Second Line	:
City	:	STEGER
State	:	IL
Zip	:	60475-1055
Country	:	US
Telephone Number	:	708-756-3037
Fax Number	:	708-756-3065

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	PAM ZUREK
Credential	:
Telephone Number	:	708-756-3037

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	03/13/2008

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