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Request a Referral

The online form below allows you to describe your needs in finding a physician. It asks only for basic information, and, as with all submissions to Condell, your request is confidential.

What Happens After You Submit the Form?

Our Physician Referral and Health Resources Coordinator is able to provide information in regards to the type of physician (specialty, gender and personality) that you are looking for.

Our free service will match your requested physician(s) with the name of your medical insurance and your location.

Feel free to call our Physician Referral and Health Resources coordinator at (847) 990-5610 for more help. To request that a physician directory be sent to you, please click here.

Fill Out This Form to Request a Referral

My Contact Information:



Email 
First Name 
Last Name 
Address 
City 
State 
Zip 
Phone 
Fax 
Type of Insurance 
HMO, PPO or Self-Pay? 
I would like to sign up to receive this information through email. In addition, I understand that I may periodically receive e-mail updates about new services, new doctors, free screenings and health promotions and other exciting events at Condell Medical Center.

Please send information about:
Condell Medical Center
Centre Club (Fitness Complex)
Condell Immediate Care
Pediatric Alternatives in Creative Therapy (Rehabilitation)
Condell Day Center
New Life Maternity Center
Other

I am interested in a referral for the following medical specialties:
Allergy/Immunology
Anesthesiology
Cardiac Surgery
Cardiology
Dentistry
Dermatology
Electrophysiology
Emergency Medicine
Endocrinology
Family Practice
Gastroenterology
General Surgery
Geriatrics
Gynecology
Gynecology-Oncology
Hand Surgery
Infectious Disease
Internal Medicine
Neonatology
Nephrology
Neurology
Neurosurgery
Obstetrics/Gynecology
Ophthalmology
Oral & Maxillofacial Surgery
Orthopedic Surgery
Otolaryngology (Ear, Nose & Throat)
Pain Management
Pediatric Allergy
Pediatric Cardiology
Pediatric Neurology
Pediatrics
Pediatric Allergy
Pedodontics
Physical Medicine/Rehabilitation
Plastic Surgery
Podiatry
Psychiatry
Pulmonary Medicine
Radiation Oncology
Reproductive Endocrinology
Rheumatology
Sports Medicine
Thoracic Surgery
Urology
Vascular Surgery
Other

   

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Schedule a Test: (847) 990-5000 | Find a Doctor: (847) 990-5610 | Main: (847) 362-2900
Condell Medical Center, 801 South Milwaukee Avenue, Libertyville, Illinois 60048.
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