Provider Demographics
NPI:1881620177
Name:ENT SURGICAL CONSULTANTS, LTD
Entity type:Organization
Organization Name:ENT SURGICAL CONSULTANTS, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:K
Authorized Official - Last Name:KRON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:815-725-1191
Mailing Address - Street 1:2201 GLENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:JOLIET
Mailing Address - State:IL
Mailing Address - Zip Code:60435-5574
Mailing Address - Country:US
Mailing Address - Phone:815-725-1191
Mailing Address - Fax:815-725-2048
Practice Address - Street 1:2201 GLENWOOD AVE
Practice Address - Street 2:
Practice Address - City:JOLIET
Practice Address - State:IL
Practice Address - Zip Code:60435-5574
Practice Address - Country:US
Practice Address - Phone:815-725-1191
Practice Address - Fax:815-725-2048
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-25
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILCH4890OtherRR MEDICARE PROV #
ILH17347Medicare UPIN
ILL92350Medicare PIN
ILL58385Medicare PIN
ILL92354Medicare PIN
ILCH4890OtherRR MEDICARE PROV #
ILH63329Medicare UPIN
ILL92352Medicare PIN
ILL58386Medicare PIN
ILL78748Medicare PIN
ILL58387Medicare PIN
ILK36670Medicare PIN
ILG55044Medicare UPIN
ILH88775Medicare UPIN
ILK08804Medicare PIN
ILF39912Medicare UPIN
ILL92094Medicare PIN
ILK08805Medicare PIN
ILL92353Medicare PIN