Provider Demographics
NPI:1538293121
Name:CONSULTANTS IN GENERAL SURGERY, S.C.
Entity Type:Organization
Organization Name:CONSULTANTS IN GENERAL SURGERY, S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:P
Authorized Official - Last Name:HAGGERTY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:847-433-1060
Mailing Address - Street 1:767 PARK AVE W
Mailing Address - Street 2:SUITE 320
Mailing Address - City:HIGHLAND PARK
Mailing Address - State:IL
Mailing Address - Zip Code:60035-2400
Mailing Address - Country:US
Mailing Address - Phone:847-433-1060
Mailing Address - Fax:847-433-1399
Practice Address - Street 1:767 PARK AVE W
Practice Address - Street 2:SUITE 320
Practice Address - City:HIGHLAND PARK
Practice Address - State:IL
Practice Address - Zip Code:60035-2400
Practice Address - Country:US
Practice Address - Phone:847-433-1060
Practice Address - Fax:847-433-1399
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL974060Medicare ID - Type Unspecified