Organization
GRAND OAKS ANESTHESIA PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JIM H. BUTLER (PRACTICE MANAGER)
(847) 549-1609
Entity
Organization
Contact information
Practice address
1800 HOLLISTER DR, #202, LIBERTYVILLE, IL 60048-5263
(847) 549-1609
(847) 549-1646
Mailing address
P.O. BOX 6329, VERNON HILLS, IL 60061-6329
(847) 549-1609
(847) 549-1646
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
042618093
IL
174400000X
Specialist
—
IL
Other
Enumeration date
08/30/2006
Last updated
08/15/2011
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