Organization
NORTHWEST SUBURBAN ENDOSCOPY, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOHN P. MORAN M.D. (PRESIDENT)
(847) 372-8096
Entity
Organization
Contact information
Practice address
113 W LAKE ST, BLOOMINGDALE, IL 60108-1006
(847) 592-6362
Mailing address
PO BOX 3223, BARRINGTON, IL 60011-3223
(847) 592-6362
(847) 304-1422
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
036084151
IL
Other
Enumeration date
04/05/2007
Last updated
09/28/2012
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