Organization
THOMAS AND THOMAS MEDICAL LTD
Active
Other names
heart and vascular center of lake county
Organization subpart
No
Provider details
NPI number
Authorized official
SHERLENE MAY GIRON DASALLA (CREDENTIALING/BILLING SPECIALIST)
(847) 336-1600
Entity
Organization
Contact information
Practice address
222 S GREENLEAF ST STE 109, GURNEE, IL 60031-5705
(847) 336-1600
(847) 336-2380
Mailing address
222 S GREENLEAF ST STE 109, GURNEE, IL 60031-5705
(847) 336-1600
(847) 336-2380
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036109155
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CG4315
MEDICAE ID TYPE UNSPECIFI
IL
Enumeration date
06/10/2006
Last updated
09/24/2025
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