Organization
GRAND OAKS SURGICAL, S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRUCE W. IRWIN M.D. (MEDICAL DIRECTOR)
(847) 549-1176
Entity
Organization
Contact information
Practice address
1800 HOLLISTER DR, SUITE 204, LIBERTYVILLE, IL 60048-5263
(847) 549-1176
Mailing address
PO BOX 5667, VERNON HILLS, IL 60061-5667
(847) 549-1176
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
—
—
Other
Enumeration date
12/22/2006
Last updated
08/22/2020
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