Organization
MSO PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE YOUNGS (BILLING)
(847) 374-5316
Entity
Organization
Contact information
Practice address
2449 E 12 MILE RD, WARREN, MI 48092-5647
(586) 558-8435
Mailing address
2333 WAUKEGAN RD, SUITE175, BANNOCKBURN, IL 60015-5508
(847) 267-0801
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
—
—
Other
Enumeration date
08/31/2006
Last updated
08/22/2020
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