ASHLAND AVENUE GI S.C. NPI 1962781252

NPI Information

ASHLAND AVENUE GI, S.C. is an endoscopy clinic center in Chicago, IL. ASHLAND AVENUE GI, S.C. NPI is 1962781252. The provider is registered as an organization entity type.

The provider's business location address is:

3004 N ASHLAND AVE
CHICAGO, IL
ZIP 60657
Phone: (773) 871-4600
Fax: (773) 871-2900

The provider's authorized official is Keikhosrow Ghazanfari .
The authorized official title is President and has the following contact phone number (773) 871-4600.

The CLIA number assigned to this NPI record is 14D2052961 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/4/2011 and was last updated on 8/4/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

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