Healthcare Provider Details

I. General information

NPI: 1598793903
Provider Name (Legal Business Name): JAMES FLAHERTY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/28/2006
Last Update Date: 08/27/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

675 N SAINT CLAIR ST GALTER 19-100
CHICAGO IL
60611-5975
US

IV. Provider business mailing address

201 E HURON ST STE 8-130
CHICAGO IL
60611-3197
US

V. Phone/Fax

Practice location:
  • Phone: 312-695-4965
  • Fax:
Mailing address:
  • Phone: 312-926-8948
  • Fax: 312-695-5774

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number036-106876
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number036106876
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: