Surgeons of Lake County LLC
NPI #1417145301 in Libertyville, Illinois
Provider Information
- NPI Number
- 1417145301
- Entity Type
- Organization
- Organization Name
- Surgeons of Lake County LLC
- Primary Specialty
- Surgery
- Enumeration Date
- Oct 4, 2007
- Last Updated
- Oct 1, 2009
Practice Location
- Address
- 1870 W WINCHESTER RD
- Address 2
- SUITE 112
- City
- Libertyville
- State
- Illinois
- ZIP Code
- 60048-5358
- Phone
- (847) 816-7495
Authorized Official
- Name
- DR. SCOTT CHRISTOPHER OTTO, M.D.
- Title
- PRESIDENT
- Phone
- (847) 816-7495
Specialties & Taxonomy Codes
| Specialty |
|---|
| Surgery |
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