Healthcare Provider Details

I. General information

NPI: 1588694343
Provider Name (Legal Business Name): PERCY CONRAD MAY II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CONRAD MAY M.D.

II. Dates (important events)

Enumeration Date: 07/04/2006
Last Update Date: 09/08/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3857 W WASHINGTON BLVD
CHICAGO IL
60624-2342
US

IV. Provider business mailing address

1030 N STATE ST 50H
CHICAGO IL
60610-5476
US

V. Phone/Fax

Practice location:
  • Phone: 773-533-1417
  • Fax: 773-533-7348
Mailing address:
  • Phone: 312-787-3657
  • Fax: 312-787-8341

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number036-038263
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: