Organization
AFFILIATED EAR, NOSE AND THROAT PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
FAY WILSON (PRACTICE MANAGER)
(815) 338-4600
Entity
Organization
Contact information
Practice address
214 WASHINGTON ST, INGLESIDE, IL 60041-9208
(847) 587-4700
(847) 587-6034
Mailing address
2441 LAKE SHORE DR, WOODSTOCK, IL 60098-6911
(815) 338-4600
(815) 338-4611
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
—
Other
Enumeration date
02/21/2007
Last updated
06/16/2008
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