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Organization
NORTH SHORE UNIVERSITY HEALTH SYSTEM
Active
Organization
NORTH SHORE UNIVERSITY HEALTH SYSTEM
Active
Parent organization
UNIVERSITY OF CHICAGO PRITZKER SCHOOL OF MEDICINE
Organization subpart
Yes
Provider details
NPI number
Legal business name
UNIVERSITY OF CHICAGO PRITZKER SCHOOL OF MEDICINE
Authorized official
DR. LIZA ICAYAN MD (PROGRAM DIRECTOR)
(847) 570-2509
Entity
Organization
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(847) 570-2509
Mailing address
9744 DEE RD, APT # 402, DES PLAINES, IL 60016-1768
(630) 842-0067
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
125057831
IL
Other
Enumeration date
10/11/2011
Last updated
10/11/2011
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