Southwest Head & Neck Surgical Assoc Sc
Otolaryngology in Orland Park, IL. Organization (NPI-2).
NPI number1104094804
StatusActive
Last updated in NPPESMay 14, 2012
Details
- NPI
- 1104094804
- Entity type
- Organization (NPI-2)
- Legal business name
- Southwest Head & Neck Surgical Assoc Sc
- Organization subpart
- No
- Enumeration date
- Feb 15, 2008
- Last updated
- May 14, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 036054754 | IL | Yes |
Other names
- Joseph P Gavron MD (Doing Business As)
Practice location
1000 Ravinia PlOrland Park, IL 60462-3764
Phone 708-460-6663 · Fax 708-460-6693
Mailing address
1000 Ravinia PlOrland Park, IL 60462-3764
Phone 708-460-6663 · Fax 708-460-6693
Authorized official
Joseph P Gavron
Owner
7084606663
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