Advocate Illinois Masonic Medical Center

NPI 1063688786 - Internal Medicine - 207R00000X

NPI Details
NPI 1063688786
Enumeration Date 05/02/2008
Last Updated 05/02/2008
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name TERESA TERESA
Position RESIDENCY PROGRAM DIRECTOR
Phone (773) 296-5424
Fax (773) 296-5280
Practice Location
3048 N WILTON AVE FL 2
CHICAGO IL, 60657-6710, US
Phone (773) 296-5424
Fax (773) 296-5280
Business Location
836 W WELLINGTON AVE
CHICAGO IL, 60657-5147, US
Phone
Fax
Toxanomy
Taxonomy Code 207R00000X
License State Illinois
License Number 125-052303
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According to our database, Advocate Illinois Masonic Medical Center NPI is 1063688786, taxonomy code is 207R00000X and license number is 125-052303, license state is located at Illinois. Advocate Illinois Masonic Medical Center physically located at 3048 N Wilton Ave Fl 2, Chicago IL, 60657-6710. NPI Number 1033115704 has the healthcare provider type.

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1063688786 NPI number is provided on an as is basis without warranty of any kind. 1063688786 is maintained by the National Plan & Provider Enumeration System. The contents of Advocate Illinois Masonic Medical Center are for informational purposes only.