Organization
ASHPOLE SURGERY CENTER LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BRADLEY ASHPOLE MD (CEO)
(847) 650-5818
Entity
Organization
Contact information
Practice address
1107 N PROSPECT AVE, ITASCA, IL 60143-1408
(847) 884-8346
Mailing address
1333 W ESTATE LN E, LAKE FOREST, IL 60045-3623
(847) 650-5818
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Enumeration date
09/19/2024
Last updated
09/19/2024
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