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NPI Code Detail

MEDICARE: ADAM BLACK MD

MEDICARE: ADAM BLACK 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
1207P00000XEmergency Medicine PhysicianIL

General Provider Information

NPI Number : 1851313241
Entity Type Code : Individual
Provider Name (Legal Business Name) : ADAM BLACK MD
Provider Business Mailing Address
First Line : PO BOX 5940
Second Line : DEPT. 20-DIV001
City : CAROL STREAM
State : IL
Zip : 60197-5940
Country : US
Telephone Number : 630-734-0200
Fax Number :
Provider Business Practice Location Address
First Line : 1431 N CLAREMONT AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60622-1702
Country : US
Telephone Number : 773-278-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/24/2006
Last Update Date : 07/08/2007

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