Organization
SUBURBAN GENERAL SURGERY LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GERALD KAMPIN MD (PRESIDENT)
(708) 425-6370
Entity
Organization
Contact information
Practice address
4700 W 95TH ST, STE 308, OAK LAWN, IL 60453
(708) 425-6370
(708) 425-6416
Mailing address
4700 W 95TH ST, STE 308, OAK LAWN, IL 60453
(708) 425-6370
(708) 425-6416
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1617379
BLUE CROSS BLUE SHIELD
IL
Enumeration date
12/13/2006
Last updated
11/20/2007
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