MEDICARE: ALAN I NEWMAN MD

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	036-066944	IL

General Provider Information

NPI Number	:	1649331646
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN I NEWMAN MD

Provider Business Mailing Address
First Line	:	6836 S CRANDON AVE
Second Line	:	UNIT 1
City	:	CHICAGO
State	:	IL
Zip	:	60649-1251
Country	:	US
Telephone Number	:	773-493-8126
Fax Number	:	773-493-8124

Provider Business Practice Location Address
First Line	:	1229 N NORTH BRANCH ST
Second Line	:	SUITE 210
City	:	CHICAGO
State	:	IL
Zip	:	60642-2473
Country	:	US
Telephone Number	:	312-939-5090
Fax Number	:	312-640-4496

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

Provider Enumeration Date	:	12/13/2006
Last Update Date	:	10/11/2012

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