Organization
BRAD K GREENSPAN
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHIRLEY ROLL (ENROLLMENT MANAGER)
(317) 472-7396
Entity
Organization
Contact information
Practice address
480 ELM PL STE 104, HIGHLAND PARK, IL 60035-2535
(847) 436-1300
Mailing address
480 ELM PL STE 104, HIGHLAND PARK, IL 60035-2535
(847) 436-1300
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
—
Other
Enumeration date
05/19/2021
Last updated
05/24/2021
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