Organization
ILLINOIS PHLEBOLOGY ASSOCIATES SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NATHAN AMORUSO (SR VP REVENUE)
(847) 593-8460
Entity
Organization
Contact information
Practice address
14225 S 95TH AVE STE 455, ORLAND PARK, IL 60462-2266
(708) 873-3450
Mailing address
PO BOX 451, NORTHBROOK, IL 60065-0451
(847) 593-8460
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
—
IL
2085R0204X
Vascular & Interventional Radiology Physician
—
IL
208600000X
Surgery Physician
Primary
—
IL
2086S0129X
Vascular Surgery Physician
—
IL
Other
Enumeration date
05/27/2006
Last updated
05/04/2023
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