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Organization
PARKSIDE OBSTETRICS & GYNECOLOGY SC
Active
Organization
PARKSIDE OBSTETRICS & GYNECOLOGY SC
Active
Other names
Parkside Obstetrics Gynceology & Infertility SC
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT G. KOSS MD (PRESIDENT)
(847) 825-1100
Entity
Organization
Contact information
Practice address
1875 DEMPSTER ST, SUITE 465, PARK RIDGE, IL 60068-1186
(847) 825-1100
(847) 825-0994
Mailing address
1875 DEMPSTER ST, SUITE 465, PARK RIDGE, IL 60068-1186
(847) 825-1100
(847) 825-0994
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617935
BLUE SHIELD
IL
01
—
50108
ADVOCATE
IL
Enumeration date
10/18/2005
Last updated
12/04/2019
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