Organization Name: | NORTH SHORE UROGYNECOLOGY LTD |
NPI Number: | 1013021922 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SANJAY GANDHI (PRESIDENT) |
Mailing Address: | 351 Greenleaf Ave E Park City |
State: | IL US |
Postal Code: | 600855701 |
Phone Number: | 8472341100 |
Fax Number: | 8477750703 |
NPI Enumeration Date: | 08/18/2006 |
NPI Last Update Date: | 02/13/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 207VG0400X |
License Number: | 036101308 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | IL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Obstetrics & Gynecology |
Taxonomy Specialization: | Gynecology |
Taxonomy Definition: |