Lake Shore Gastroenterology

NPI #1588780894 in Evanston, Illinois

Provider Information

NPI Number
1588780894
Entity Type
Organization
Organization Name
Lake Shore Gastroenterology
Primary Specialty
Internal Medicine - Gastroenterology
Enumeration Date
Mar 21, 2007
Last Updated
Aug 27, 2007

Practice Location

Address
800 AUSTIN ST
Address 2
SUITE 403 WEST TOWER
ZIP Code
60202-3439
Phone
(847) 491-9020

Authorized Official

Name
WALTER REID GLAWS, DO
Title
PRESIDENT
Phone
(847) 244-2960

Specialties & Taxonomy Codes

Specialty
Internal Medicine - GastroenterologyGastroenterology

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