Organization
DOCTORS OF THE NORTH SHORE SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JENNIFER PFEIFER (PRACTICE MANAGER)
(847) 967-5010
Entity
Organization
Contact information
Practice address
6131 W DEMPSTER, MORTON GROVE, IL 60053
(847) 967-5010
(847) 967-5147
Mailing address
6131 W DEMPSTER, MORTON GROVE, IL 60053
(847) 967-5010
(847) 967-5147
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01632926
BLUE CROSS BLUE SHIELD
IL
Enumeration date
02/21/2006
Last updated
02/04/2010
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