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Organization
WESTLAKE MEDICAL ASSOCIATES, LTD
Active
Organization
WESTLAKE MEDICAL ASSOCIATES, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSAN GOODMAN (OFFICE MANAGER)
(847) 984-6452
Entity
Organization
Contact information
Practice address
565 LAKEVIEW PKWY, SUITE 117, VERNON HILLS, IL 60061-1857
(847) 984-6450
(847) 984-6451
Mailing address
565 LAKEVIEW PKWY, SUITE 117, VERNON HILLS, IL 60061-1857
(847) 984-6450
(847) 984-6451
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
36081366
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4932473
BLUE CROSS
IL
Enumeration date
04/03/2007
Last updated
12/18/2007
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