Provider Demographics
NPI:1487724852
Name:WEST SUBURBAN GASTROENTEROLOGY S C
Entity type:Organization
Organization Name:WEST SUBURBAN GASTROENTEROLOGY S C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:F
Authorized Official - Last Name:DEUTSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:708-763-6585
Mailing Address - Street 1:1 ERIE COURT
Mailing Address - Street 2:STE 3100
Mailing Address - City:OAK PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60302
Mailing Address - Country:US
Mailing Address - Phone:708-763-8248
Mailing Address - Fax:708-763-8248
Practice Address - Street 1:1 ERIE COURT
Practice Address - Street 2:STE 3100
Practice Address - City:OAK PARK
Practice Address - State:IL
Practice Address - Zip Code:60302
Practice Address - Country:US
Practice Address - Phone:708-763-8248
Practice Address - Fax:708-763-8248
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2008-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty