Organization
CANSLER HEALTH ASSO., S.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GAIL D.H. CANSLER M.D. (PRESIDENT)
(709) 755-3300
Entity
Organization
Contact information
Practice address
30 E 15TH ST, SUITE 306, CHICAGO HEIGHTS, IL 60411-3459
(708) 755-3300
Mailing address
30 E 15TH ST, SUITE 306, CHICAGO HEIGHTS, IL 60411-3459
(708) 755-3300
Taxonomy
Speciality
Code
Description
License number
State
261QM2500X
Medical Specialty Clinic/Center
Primary
036066127
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
036066127
—
IL
Enumeration date
08/24/2007
Last updated
08/24/2007
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