Organization
CENTURY EAR NOSE AND THROAT - HEAD AND NECK SURGERY ASSOCIATES LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN P FARRELL M.D. (DOCTOR)
(708) 460-0008
Entity
Organization
Contact information
Practice address
16001 108TH AVE, ORLAND PARK, IL 60467-8788
(708) 460-0007
(708) 460-0005
Mailing address
10660 W 143RD ST, SUITE B, ORLAND PARK, IL 60462-1989
(708) 460-4499
(708) 460-8031
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01607201
BLUE CROSS BLUE SHIELD
IL
01
—
CM5539
PALMETTO RR MEDICARE
IL
Enumeration date
09/15/2006
Last updated
09/04/2012
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