Organization
SURGEONS GROUP, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARY DALE HOUSTON R.N. (OFFICE MANAGER)
(847) 234-4310
Entity
Organization
Contact information
Practice address
800 N WESTMORELAND RD, SUITE 205, LAKE FOREST, IL 60045-1673
(847) 234-4310
(847) 234-4336
Mailing address
800 N WESTMORELAND RD, SUITE 205, LAKE FOREST, IL 60045-1673
(847) 234-4310
(847) 234-4336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
042-000369
IL
208C00000X
Colon & Rectal Surgery Physician
042-000369
IL
Other
Enumeration date
01/25/2006
Last updated
08/31/2010
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