Organization
LAKE FOREST CARDIOLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. SRISH SRIRAM (MEMBER)
(847) 615-2273
Entity
Organization
Contact information
Practice address
611 HUNTER LN, LAKE FOREST, IL 60045-4905
(847) 615-2273
Mailing address
611 HUNTER LN, LAKE FOREST, IL 60045-4905
(847) 615-2273
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
036088401
IL
Other
Enumeration date
10/18/2011
Last updated
10/18/2011
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