Healthcare Provider Details

I. General information

NPI: 1912993411
Provider Name (Legal Business Name): JAMES G ADAMS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2005
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 E HURON ST EMERGENCY ROOM
CHICAGO IL
60611-2909
US

IV. Provider business mailing address

680 N LAKE SHORE DR SUITE 1000
CHICAGO IL
60611-4546
US

V. Phone/Fax

Practice location:
  • Phone: 312-926-5222
  • Fax: 312-926-6274
Mailing address:
  • Phone: 312-695-9797
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number036101993
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: