Organization
GREATER ELGIN EMERGENCY SPECIALISTS LTD
Active
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
Update your record
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