Organization
CARDIOTHORACIC ENDOSCOPIC SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALAN S PANARES CSA (CEO)
(312) 593-0824
Entity
Organization
Contact information
Practice address
800 BIESTERFIELD ROAD, ELK GROVE VILLAGE, IL 60007-3397
(847) 437-5500
Mailing address
4717 W. PENSACOLA AVE., CHICAGO, IL 60641-1683
(312) 593-0824
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
238.000082
IL
Other
Enumeration date
05/09/2011
Last updated
05/09/2011
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