Affiliated Ear, Nose and Throat Physicians

Organization Active NPI Otolaryngology Physician · Ingleside, IL

NPI 1619012010 · NPPES record last updated Jun 16, 2008

Key facts

NPI
1619012010
Entity type
Organization (NPI type 2)
Primary specialty
Otolaryngology Physician 207Y00000X
Legal business name
AFFILIATED EAR, NOSE AND THROAT PHYSICIANS
Practice address
214 Washington St
Ingleside, IL 60041-9208
Phone
(847) 587-4700
Fax
(847) 587-6034
NPI assigned
Feb 21, 2007
Organization subpart
No

Authorized official

Name
Fay Wilson
Title
Practice Manager
Phone
(815) 338-4600

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Tax ID family
Affiliated Ear Nose and Throat Physicians (2 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician
Group: 193400000X SINGLE SPECIALTY GROUP
207Y00000X Yes

Addresses

Primary practice location

214 Washington St
Ingleside, IL 60041-9208

Mailing address

2441 Lake Shore Dr
Woodstock, IL 60098-6911
Phone (815) 338-4600

Other providers in Ingleside, IL

All providers in Ingleside, IL · Otolaryngology Physician in Illinois

Sources for this page

Verify at the official NPI Registry.