Organization
GASTROENTEROLOGY AND LIVER DISEASE ASSOCIATES LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARC S FINE MD (MANAGING PARTNER DOCTOR)
(847) 318-9595
Entity
Organization
Contact information
Practice address
7900 N MILWAUKEE AVE, SUITE 19, NILES, IL 60714-3159
(847) 318-9595
(847) 318-9599
Mailing address
7900 N MILWAUKEE AVE, SUITE 19, NILES, IL 60714-3159
(847) 318-9595
(847) 318-9599
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CJ6281
RAIL ROAD MEDICARE
IL
Enumeration date
12/01/2006
Last updated
10/26/2007
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