Organization
LAKE SHORE GASTROENTEROLOGY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
WALTER REIS GLAWS DO (PRESIDENT)
(847) 244-2960
Entity
Organization
Contact information
Practice address
9701 KNOX AVE, SUITE 103, SKOKIE, IL 60076-1256
(847) 433-9840
(847) 433-9842
Mailing address
20 TOWER CT, SUITE C, GURNEE, IL 60031-5711
(847) 244-2960
(847) 244-2986
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
—
IL
Other
Enumeration date
03/22/2007
Last updated
08/27/2007
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