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Physicians Anesthesiology Addiction Medicine

Provider NPI: 1013136282

Organization Information:
Organization is not Subpart
Authorized Official:  VICTORIA  LEVITSKE  DIRECTOR OF FINANCE  312-996-0566

Practice Location:
1740 W TAYLOR ST  CHICAGO, IL 60612-7232 US
Tel: 312-996-4020  Fax: --

Business Mailing Address:
135 S LA SALLE ST DEPT 3452 CHICAGO, IL 60674-3452 US
Tel: --  Fax: --

NPI Information:
NPI: 1013136282
Entity Type: Organization


PrimaryCodeCategory/DescriptionStateLicense Number
Addiction Medicine

Other Provider Identifiers:

BCBS GROUP01618789IL01

American Medical Association 2012 taxonomy code information

Code: 207L00000X





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