LAKE SHORE OB GYN OF DECATUR S C is a specialist in Decatur, IL. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. LAKE SHORE OB GYN OF DECATUR S C NPI is 1700925583. The provider is registered as an organization entity type and is a single specialty group.
The provider's business location address is:
1770 E LAKE SHORE DR
SUITE 303
DECATUR, IL
ZIP 62521-832
Phone: (217) 429-4119
Fax: (217) 429-0108
The provider's authorized official is Adel Samy Hanna .
The authorized official title is Owner and has the following contact phone number (217) 429-4119.
The enumeration date for this NPI number is 2/6/2007 and was last updated on 7/25/2013.