Lake Forest Ear Nose and Throat Ltd

NPI #1124140652 in Lake Forest, Illinois

Provider Information

NPI Number: 1124140652
Entity Type: Organization
Organization Name: Lake Forest Ear Nose and Throat Ltd
Primary Specialty: Otolaryngology
Enumeration Date: Apr 4, 2007
Last Updated: Oct 26, 2010

Practice Location

Address: 700 N WESTMORELAND RD
Address 2: BLD F
City: Lake Forest
State: Illinois
ZIP Code: 60045-1679
Phone: (847) 295-1114

Authorized Official

Name: DR. LESLIE JAY BLOCK, MD
Title: PRESIDENT
Phone: (847) 295-1114

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Otolaryngology	207Y00000X	Primary

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