Organization
LAKE COOK SURGICAL ASSOCIATES PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JANICE R. KLICH M.D. (PRESIDENT)
(847) 635-9006
Entity
Organization
Contact information
Practice address
1600 DEMPSTER ST, SUITE 102, PARK RIDGE, IL 60068-1109
(847) 635-9006
Mailing address
520 E 22ND ST, LOMBARD, IL 60148-6110
(630) 874-2542
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
—
—
Other
Enumeration date
08/04/2005
Last updated
07/16/2007
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