Provider Demographics
NPI:1003954827
Name:NORTHSHORE CENTER FOR GASTROENTEROLOGY, SC
Entity Type:Organization
Organization Name:NORTHSHORE CENTER FOR GASTROENTEROLOGY, SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ARKAN
Authorized Official - Middle Name:I
Authorized Official - Last Name:ALRASHID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-247-0187
Mailing Address - Street 1:1880 W WINCHESTER RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LIBERTYVILLE
Mailing Address - State:IL
Mailing Address - Zip Code:60048-5341
Mailing Address - Country:US
Mailing Address - Phone:847-247-0187
Mailing Address - Fax:847-247-0487
Practice Address - Street 1:1880 W WINCHESTER RD
Practice Address - Street 2:SUITE 201
Practice Address - City:LIBERTYVILLE
Practice Address - State:IL
Practice Address - Zip Code:60048-5341
Practice Address - Country:US
Practice Address - Phone:847-247-0187
Practice Address - Fax:847-247-0487
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-02
Last Update Date:2012-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL110136967OtherMEDICARE RAILROAD
IL100016697OtherMEDICARE RAILRAOD
ILP00214785OtherMEDICARE RAILROAD
IL209335Medicare PIN