Healthcare Provider Details

I. General information

NPI: 1417072943
Provider Name (Legal Business Name): EMERGENCY TREATMENT, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2007
Last Update Date: 07/10/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2000 OGDEN AVE
AURORA IL
60504-7222
US

IV. Provider business mailing address

2142 N SEDGWICK ST
CHICAGO IL
60614-4620
US

V. Phone/Fax

Practice location:
  • Phone: 630-978-4810
  • Fax: 630-978-6802
Mailing address:
  • Phone: 773-327-0777
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. MARSHALL B. SEGAL
Title or Position: PRESIDENT
Credential: M.D.
Phone: 773-327-0777