Organization
NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES
Active
Other names
NorthShore Radiology Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOSEPH GOLBUS (PRESIDENT)
(847) 570-2503
Entity
Organization
Contact information
Practice address
2650 RIDGE AVE, DEPT OF RADIOLOGY, G507, EVANSTON, IL 60201-1718
(847) 570-2553
Mailing address
2650 RIDGE AVE, DEPT OF RADIOLOGY, G507, EVANSTON, IL 60201-1718
(847) 570-2553
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0000646
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1632065
BCBS
IL
01
—
DA8052
RAILROAD
IL
Enumeration date
07/03/2008
Last updated
05/11/2015
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