Organization
CHILDRENS GASTROENTEROLOGY SPECIALISTS SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUZANNE P NELSON MD (SOLE PROPRIETOR)
(847) 724-7825
Entity
Organization
Contact information
Practice address
2551 COMPASS RD, SUITE 110, GLENVIEW, IL 60026-8045
(847) 724-7825
(847) 724-7845
Mailing address
777 OAKMONT LN, SUITE 1600, WESTMONT, IL 60559-5511
(630) 789-2550
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1634323
BCBS PROVIDER ID
IL
Enumeration date
09/21/2006
Last updated
01/28/2008
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