Organization
ELGIN GASTROENTEROLOGY ENDOSCOPY CENTER LLC
Active
Other names
The Endo Center of Elgin Gastroenterology
Organization subpart
No
Provider details
NPI number
Authorized official
CARRIE LYNN LAWLOR (ADMINISTRATOR)
(847) 888-5711
Entity
Organization
Contact information
Practice address
745 FLETCHER DR FL 2, ELGIN, IL 60123-4747
(847) 888-1300
(847) 888-1341
Mailing address
745 FLETCHER DR STE 201, ELGIN, IL 60123-4749
(847) 888-5712
(847) 608-8166
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
1710262
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50438
BLUE SHIELD
IL
Enumeration date
11/09/2006
Last updated
11/04/2025
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