| North Shore University Health System | |
|
2650 Ridge Ave Evanston IL 60201-1718 | |
| (847) 570-2509 | |
| Not Available |
| Full Name | North Shore University Health System |
|---|---|
| Speciality | Internal Medicine |
| Location | 2650 Ridge Ave, Evanston, Illinois |
| Authorized Official Name and Position | Liza Icayan (PROGRAM DIRECTOR) |
| Authorized Official Contact | 8475702509 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore University Health System 9744 Dee Rd Apt # 402 Des Plaines IL 60016-1768 Ph: (630) 842-0067 | North Shore University Health System 2650 Ridge Ave Evanston IL 60201-1718 Ph: (847) 570-2509 |
| NPI Number | 1508141441 |
|---|---|
| Provider Enumeration Date | 10/11/2011 |
| Last Update Date | 10/11/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1508141441 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 125057831 (Illinois) | Primary |
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