Healthcare Provider Details

I. General information

NPI: 1992730030
Provider Name (Legal Business Name): HAROLD MICHAEL SY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 08/06/2024
Certification Date: 08/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5086 N ELSTON AVE
CHICAGO IL
60630-2427
US

IV. Provider business mailing address

5086 N ELSTON AVE
CHICAGO IL
60630-2427
US

V. Phone/Fax

Practice location:
  • Phone: 773-282-2000
  • Fax:
Mailing address:
  • Phone: 773-282-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207WX0120X
TaxonomyCornea and External Diseases Specialist Physician
License Number036113980
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: