Organization
GREATER ELGIN EMERGENCY SPECIALISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TRACY BOSTROM (DIRECTOR OF CLIENT SERVICES)
(630) 321-8300
Entity
Organization
Contact information
Practice address
934 CENTER ST, ELGIN, IL 60120-2125
(847) 742-9800
Mailing address
810 QUAIL RIDGE DR, WESTMONT, IL 60559-6149
(630) 321-8300
(630) 321-8750
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
036078511
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
04532206
BLUE CROSS & BLUE SHIELD
IL
Enumeration date
07/09/2006
Last updated
09/14/2009
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