MEDICARE: DR. NORMAN M JAMES M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician		IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	03520750389	OTHER		AMERICAN MEDICAL ASSOCIAT
2	L037835	OTHER		CHAMPUS
3	31602322	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1639236706
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. NORMAN M JAMES M.D.

Provider Business Mailing Address
First Line	:	443 E 31ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-4051
Country	:	US
Telephone Number	:	312-225-2055
Fax Number	:	312-225-7437

Provider Business Practice Location Address
First Line	:	443 E 31ST ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60616-4051
Country	:	US
Telephone Number	:	312-225-2055
Fax Number	:	312-225-7437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/02/2007
Last Update Date	:	07/08/2007

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