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Organization

AURORA CHICAGO LAKESHORE HOSPITAL LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
PHYLLIS REMER (BILLING MGR)
(847) 433-0057
Entity
Organization

Contact information

Practice address
4840 N MARINE DR, CHICAGO, IL 60640-7860
(773) 878-9700
Mailing address
4840 N MARINE DR, CHICAGO, IL 60640-7860
(773) 878-9700

Taxonomy

Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
036109024
IL
2084P0804X
Child & Adolescent Psychiatry Physician
036111615
IL
2084P0804X
Child & Adolescent Psychiatry Physician
036113400
IL
2084P0804X
Child & Adolescent Psychiatry Physician
036118379
IL

Other

Enumeration date
10/02/2009
Last updated
11/23/2009
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