| Endoscopy Center Of The North Shore, Llc | |
|
1732 Central St Evanston IL 60201-1508 | |
| (847) 256-1855 | |
| (866) 375-3001 |
| Full Name | Endoscopy Center Of The North Shore, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1732 Central St, Evanston, Illinois |
| Authorized Official Name and Position | Vlad Halai (MANAGER) |
| Authorized Official Contact | 8472561855 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Endoscopy Center Of The North Shore, Llc 1732 Central St Evanston IL 60201-1508 Ph: (847) 256-1855 | Endoscopy Center Of The North Shore, Llc 1732 Central St Evanston IL 60201-1508 Ph: (847) 256-1855 |
| NPI Number | 1013487388 |
|---|---|
| Provider Enumeration Date | 11/29/2018 |
| Last Update Date | 04/10/2023 |
| Medicare PECOS PAC ID | 8729327101 |
|---|---|
| Medicare Enrollment ID | O20190301000212 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1013487388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | (* (Not Available)) | Primary |
| Provider Name | Laura K Bianchi |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1932231115 PECOS PAC ID: 8123125648 Enrollment ID: I20070517000582 |
| Provider Name | Manoj Kumar Mehta |
|---|---|
| Provider Type | Practitioner - Gastroenterology |
| Provider Identifiers | NPI Number: 1962495200 PECOS PAC ID: 2961582564 Enrollment ID: I20100611000763 |
| Provider Name | Jim Zb Lu |
|---|---|
| Provider Type | Practitioner - Pathology |
| Provider Identifiers | NPI Number: 1073590337 PECOS PAC ID: 4981505211 Enrollment ID: I20120727000410 |
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