Organization
NORTH SUBURBAN NEPHROLOGY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALID N GHANTOUS MD (CEO MEMBER)
(847) 446-3200
Entity
Organization
Contact information
Practice address
1425 N HUNT CLUB RD STE 301, GURNEE, IL 60031-2639
(847) 855-9252
(847) 855-5215
Mailing address
120 W 22ND ST STE 200, OAK BROOK, IL 60523-1563
(630) 573-5000
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
01553437
IL
Other
Enumeration date
11/20/2008
Last updated
04/12/2022
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