Organization
SUBURBAN OTOLARYNGOLOGY,S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LARRY L BAILEY MD (PRESIDENT)
(708) 749-3070
Entity
Organization
Contact information
Practice address
3340 OAK PARK AVE, BERWYN, IL 60402-3420
(708) 749-3070
(708) 749-3410
Mailing address
3340 OAK PARK AVE, BERWYN, IL 60402-3420
(708) 749-3070
(708) 749-3410
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0040148033
IL
Other
Enumeration date
05/15/2007
Last updated
12/13/2007
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