Provider Demographics
NPI:1952345308
Name:MID NORTH GASTROENTEROLOGISTS LTD
Entity Type:Organization
Organization Name:MID NORTH GASTROENTEROLOGISTS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:SHARON
Authorized Official - Middle Name:B
Authorized Official - Last Name:BINKER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:773-334-7581
Mailing Address - Street 1:4646 N MARINE DR
Mailing Address - Street 2:SUITE 5100
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60640-5759
Mailing Address - Country:US
Mailing Address - Phone:773-334-7581
Mailing Address - Fax:773-334-0014
Practice Address - Street 1:4646 N MARINE DR
Practice Address - Street 2:SUITE 5100
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60640-5759
Practice Address - Country:US
Practice Address - Phone:773-334-7581
Practice Address - Fax:773-334-0014
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-16
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty