Organization
NORTHERN ILLINOIS EMERGENCY SURGICAL SERV LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANTHONY E RASPANTI MD (DIRECTOR)
(708) 867-4949
Entity
Organization
Contact information
Practice address
2650 RIDGE AVE, EVANSTON, IL 60201-1718
(708) 867-4949
(708) 867-4981
Mailing address
PO BOX 56341, CHICAGO, IL 60656-0341
(708) 867-4949
(708) 867-4981
Taxonomy
Speciality
Code
Description
License number
State
2086S0102X
Surgical Critical Care Physician
Primary
—
IL
2086S0127X
Trauma Surgery Physician
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001629966
BC BS OF IL GROUP NUMBER
IL
Enumeration date
10/09/2006
Last updated
09/28/2009
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