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Organization

SUBURBAN LUNG ASSOCIATES SC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EDWARD J DIAMOND M.D. (PRESIDENT)
(847) 981-3660
Entity
Organization

Contact information

Practice address
800 BIESTERFIELD RD, SUITE 510, ELK GROVE VILLAGE, IL 60007-3311
(847) 981-3660
(847) 956-5108
Mailing address
800 BIESTERFIELD RD, SUITE 510, ELK GROVE VILLAGE, IL 60007-3311
(847) 981-3660
(847) 956-5108

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
042005859
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1617373
BCBC OF IL
IL
Enumeration date
05/13/2006
Last updated
10/27/2008
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