Organization
GASTROENTEROLOGISTS LTD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS RASHIDA R (MANAGER)
(847) 680-5880
Entity
Organization
Contact information
Practice address
1105 W PARK AVE STE 1, LIBERTYVILLE, IL 60048-2567
(847) 680-5880
(847) 680-5881
Mailing address
1105 W PARK AVE STE 1, LIBERTYVILLE, IL 60048-2567
(847) 680-5880
(847) 680-5881
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4901136
BLUE CROSS BLUE SHIELD
IL
Enumeration date
07/03/2007
Last updated
08/22/2020
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