Healthcare Provider Details

I. General information

NPI: 1689004863
Provider Name (Legal Business Name): EMERGENCY MEDICAL SPECIALISTS, II, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/25/2013
Last Update Date: 11/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3435 W VAN BUREN ST
CHICAGO IL
60624-3312
US

IV. Provider business mailing address

900 OAKMONT LN SUITE 100
WESTMONT IL
60559-5530
US

V. Phone/Fax

Practice location:
  • Phone: 773-826-6300
  • Fax: 630-734-1560
Mailing address:
  • Phone: 630-734-0200
  • Fax: 630-734-1560

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: TUNJI LADIPO
Title or Position: PRESIDENT
Credential: MD
Phone: 773-550-5550