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Organization
GRAYSLAKE FAMILY HEALTH CENTER SC
Active
Organization
GRAYSLAKE FAMILY HEALTH CENTER SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALISON S HOLLOWAY MD (PHYSICIAN PRESIDENT)
(847) 548-8430
Entity
Organization
Contact information
Practice address
1475 E BELVIDERE RD, SUITE 312, GRAYSLAKE, IL 60030-2012
(847) 845-7213
(312) 694-0655
Mailing address
1475 E BELVIDERE RD, SUITE 312, GRAYSLAKE, IL 60030-2012
(847) 584-5721
(312) 964-1468
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
036098167
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036098167
—
IL
Enumeration date
11/29/2006
Last updated
01/22/2014
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