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Organization

LAKE FOREST EAR NOSE AND THROAT LTD

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. LESLIE JAY BLOCK MD (PRESIDENT)
(847) 295-1114
Entity
Organization

Contact information

Practice address
700 N WESTMORELAND RD, BLD F, LAKE FOREST, IL 60045-1679
(847) 295-1114
(847) 295-9373
Mailing address
700 N WESTMORELAND RD, BLD F, LAKE FOREST, IL 60045-1679
(847) 295-1114
(847) 295-9373

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
036048252
IL

Other

Enumeration date
04/04/2007
Last updated
10/26/2010
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