Organization
SKYLINE NEUROSCIENCE ASSOCIATES, LLC
Active
Other names
Waukegan Clinic Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
LOUIS R JOSEPH III (VICE PRESIDENT)
(615) 373-7630
Entity
Organization
Contact information
Practice address
3443 DICKERSON PIKE STE 580, NASHVILLE, TN 37207-2526
(615) 860-1351
(615) 860-1242
Mailing address
2000 HEALTH PARK DR, BRENTWOOD, TN 37027-4525
(615) 860-1351
(866) 831-4898
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
036143179
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036143179
—
IL
05
—
1306937289
—
IL
05
—
204872623
—
IL
Enumeration date
06/17/2006
Last updated
07/19/2019
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