Healthcare Provider Details

I. General information

NPI: 1407295223
Provider Name (Legal Business Name): JAMES YORK LINDSEY M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/14/2013
Last Update Date: 06/14/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5841 S MARYLAND AVE MC 5068
CHICAGO IL
60637-1447
US

IV. Provider business mailing address

1322 S PRAIRIE AVE UNIT 1603
CHICAGO IL
60605-3496
US

V. Phone/Fax

Practice location:
  • Phone: 773-702-9500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number125-062887
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: