Provider Demographics
NPI:1245424993
Name:ELGIN BARRINGTON NEUROSURGERY SC
Entity Type:Organization
Organization Name:ELGIN BARRINGTON NEUROSURGERY SC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:Y
Authorized Official - Last Name:WEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-695-6611
Mailing Address - Street 1:87 N AIRLITE ST STE 220
Mailing Address - Street 2:
Mailing Address - City:ELGIN
Mailing Address - State:IL
Mailing Address - Zip Code:60123-4995
Mailing Address - Country:US
Mailing Address - Phone:847-695-6611
Mailing Address - Fax:847-695-8069
Practice Address - Street 1:87 N AIRLITE ST STE 220
Practice Address - Street 2:
Practice Address - City:ELGIN
Practice Address - State:IL
Practice Address - Zip Code:60123-4995
Practice Address - Country:US
Practice Address - Phone:847-695-6611
Practice Address - Fax:847-695-8069
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-05
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL21602371OtherBLUE CROSS BLUE SHIELD