Lake Forest Ear Nose And Throat Ltd
Otolaryngology in Lake Forest, IL. Organization (NPI-2).
NPI number1124140652
StatusActive
Last updated in NPPESOct 26, 2010
Details
- NPI
- 1124140652
- Entity type
- Organization (NPI-2)
- Legal business name
- Lake Forest Ear Nose And Throat Ltd
- Organization subpart
- No
- Enumeration date
- Apr 4, 2007
- Last updated
- Oct 26, 2010
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 207Y00000X | Otolaryngology | 036048252 | IL | Yes |
Practice location
700 N Westmoreland RdBld F
Lake Forest, IL 60045-1679
Phone 847-295-1114 · Fax 847-295-9373
Mailing address
700 N Westmoreland RdBld F
Lake Forest, IL 60045-1679
Phone 847-295-1114 · Fax 847-295-9373
Authorized official
Leslie Jay Block
President
8472951114
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