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Organization

ANDREW J KONTRICK MDSC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
ANDREW J KONTRICK MD (OWNER SERVICE CORPORATION)
(847) 244-5884
Entity
Organization

Contact information

Practice address
35 TOWER COURT, SUITE I, GURNEE, IL 60031-5712
(847) 244-5884
(847) 244-0547
Mailing address
35 TOWER COURT, SUITE I, GURNEE, IL 60031-5712
(847) 244-5884
(847) 244-0547

Taxonomy

Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
03604585865
IL
01
04926221
BCBS
Enumeration date
11/27/2006
Last updated
08/22/2020
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