Organization
NORTHWESTERN BREAST SURGEONS, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN P BETHKE M.D. (PRESIDENT)
(847) 702-8050
Entity
Organization
Contact information
Practice address
676 N SAINT CLAIR ST, SUITE 1525, CHICAGO, IL 60611-2927
(312) 943-2746
(312) 266-1411
Mailing address
676 N SAINT CLAIR ST, SUITE 1525, CHICAGO, IL 60611-2927
(312) 943-2746
(312) 266-1411
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036.082564
IL
Other
Enumeration date
12/23/2014
Last updated
12/23/2014
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