Organization
VA MEDICAL CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THALERNG BALACHANDRA (PHYSICIAN)
(847) 688-1900
Entity
Organization
Contact information
Practice address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
(847) 688-1900
Mailing address
3001 GREEN BAY RD, NORTH CHICAGO, IL 60064-3048
Taxonomy
Speciality
Code
Description
License number
State
282N00000X
General Acute Care Hospital
Primary
36059758
IL
Other
Enumeration date
07/26/2007
Last updated
07/26/2007
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