Provider Demographics
NPI:1790763407
Name:NEUROLOGY SPECIALISTS OF NORTHERN ILLINOIS
Entity Type:Organization
Organization Name:NEUROLOGY SPECIALISTS OF NORTHERN ILLINOIS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LORI
Authorized Official - Middle Name:A
Authorized Official - Last Name:KIRBY-PEARCE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:847-627-8701
Mailing Address - Street 1:9301 GOLF RD
Mailing Address - Street 2:SUITE 303
Mailing Address - City:DES PLAINES
Mailing Address - State:IL
Mailing Address - Zip Code:60016-1667
Mailing Address - Country:US
Mailing Address - Phone:847-298-4088
Mailing Address - Fax:847-627-8700
Practice Address - Street 1:9301 GOLF RD
Practice Address - Street 2:SUITE 303
Practice Address - City:DES PLAINES
Practice Address - State:IL
Practice Address - Zip Code:60016-1667
Practice Address - Country:US
Practice Address - Phone:847-298-4088
Practice Address - Fax:847-627-8700
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL902510Medicare ID - Type UnspecifiedGROUP NUMBER