Healthcare Provider Details

I. General information

NPI: 1285673871
Provider Name (Legal Business Name): ER ASSOCIATES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2233 W DIVISION ST
CHICAGO IL
60622-3043
US

IV. Provider business mailing address

DEPT. 20-5038 PO BOX 5988
CAROL STREAM IL
60197
US

V. Phone/Fax

Practice location:
  • Phone: 312-770-2000
  • Fax:
Mailing address:
  • Phone: 630-734-0200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SCOTT J. BETZELOS
Title or Position: PRESIDENT
Credential:
Phone: 773-728-5133