# LAKE COOK SURGICAL ASSOCIATES PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1801897434
- **Authorized official:** JANICE R. KLICH M.D. (PRESIDENT)
- **Authorized official phone:** (847) 635-9006

## Contact information

- **Practice address:** 1600 DEMPSTER ST, SUITE 102, PARK RIDGE, IL 60068-1109
- **Practice address phone:** (847) 635-9006
- **Mailing address:** 520 E 22ND ST, LOMBARD, IL 60148-6110
- **Mailing address phone:** (630) 874-2542

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | NULL | Yes |
| 208G00000X | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician | — | — | Yes |

## Other

- **Enumeration date:** 08/04/2005
- **Last updated:** 07/16/2007