| Infectious Disease Specialists Of Chicago | |
|
600 S Paulina St Suite 143 Chicago IL 60612-3806 | |
| (312) 942-2061 | |
| (312) 942-2184 |
| Full Name | Infectious Disease Specialists Of Chicago |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 600 S Paulina St, Chicago, Illinois |
| Authorized Official Name and Position | Gordon M Trenholme (PRESIDENT) |
| Authorized Official Contact | 3129422061 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Specialists Of Chicago Po Box 239d Park Ridge IL 60068-8018 Ph: (847) 732-8087 | Infectious Disease Specialists Of Chicago 600 S Paulina St Suite 143 Chicago IL 60612-3806 Ph: (312) 942-2061 |
| NPI Number | 1194786574 |
|---|---|
| Provider Enumeration Date | 03/28/2006 |
| Last Update Date | 12/03/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1194786574 | NPI | - | NPPES |
| 21623155 | Other | IL | BLUE SHIELD GROUP # |
| CJ6213 | Other | IL | RR MEDICARE GROUP # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (Illinois) | Primary |
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