Organization
ENDOCRINOLOGY CONSULTS AND CARE SERVICE CORPORATION
Active
Other names
Endocrinology Consults and Care Service Corporation
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SUSAN SHAPIRO BRAITHWAITE M.D. (PRESIDENT)
(847) 906-4910
Entity
Organization
Contact information
Practice address
3048 W PETERSON AVE, CHICAGO, IL 60659-3720
(773) 381-0517
(773) 381-0617
Mailing address
1135 RIDGE RD, WILMETTE, IL 60091-1567
(847) 906-4910
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F100165220
MEDICARE ID
IL
Enumeration date
09/05/2014
Last updated
03/01/2016
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