Organization
PEDIATRIC UROLOGY PARTNERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE FLOM MD (OWNER)
(847) 297-8700
Entity
Organization
Contact information
Practice address
1440 RENAISSANCE DR, SUITE 220, PARK RIDGE, IL 60068-1356
(847) 297-8700
(847) 297-8760
Mailing address
1440 RENAISSANCE DR, SUITE 220, PARK RIDGE, IL 60068-1356
(847) 297-8700
(847) 297-8760
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
036071644
IL
Other
Enumeration date
07/15/2006
Last updated
06/23/2008
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