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Organization

LAKE FOREST ENDOSCOPY CENTER LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. TAMMY HAM (DIRECTOR)
(816) 877-2005
Entity
Organization

Contact information

Practice address
1475 E BELVIDERE RD, SUITE 303, GRAYSLAKE, IL 60030-2012
(219) 789-9176
Mailing address
1475 E BELVIDERE RD, SUITE 303, GRAYSLAKE, IL 60030-2012
(219) 789-9176

Taxonomy

Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary

Other

Enumeration date
02/27/2008
Last updated
02/27/2008
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