Organization
BELMONT HARLEM ANESTHESIA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MIKE JENNINGS (DIRECTOR OF FINANCE)
(630) 537-1720
Entity
Organization
Contact information
Practice address
3101 N HARLEM AVE, BELMONT HARLEM SURGERY CENTER, CHICAGO, IL 60634-4543
(773) 889-2000
Mailing address
PO BOX 631, LAKE FOREST, IL 60045-0631
(847) 615-2200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
207L00000X
TAXONOMY
IL
Enumeration date
03/27/2013
Last updated
06/05/2013
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