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Organization

VASCULAR SURGERY & NONINVASIVE DIAGNOSTICS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JOSEPH DURHAM M.D. (PRESIDENT)
(773) 206-7197
Entity
Organization

Contact information

Practice address
1 INGALLS DRIVE, LL-NORTH BLDG, HARVEY, IL 60426
(708) 915-4588
Mailing address
10347 S LONGWOOD DR, CHICAGO, IL 60643-2610
(773) 206-7197

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
01628302
BLUE CROSS BLUE SHIELD
IL
Enumeration date
11/15/2006
Last updated
07/21/2022
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