Organization
GOLF WESTERN SURGICAL SPECIALISTS, LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOUBIN KHORSAND M.D. (PRESIDENT)
(847) 299-8844
Entity
Organization
Contact information
Practice address
8901 GOLF RD, SUITE 305, DES PLAINES, IL 60016-6850
(847) 299-8844
(847) 299-6420
Mailing address
8901 GOLF RD, SUITE 305, DES PLAINES, IL 60016-6850
(847) 299-8844
(847) 299-6420
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036055404
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01617001
BLUE CROSS BLUE SHIELD
IL
05
—
036055404
—
IL
Enumeration date
11/20/2006
Last updated
01/24/2011
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