Healthcare Provider Details

I. General information

NPI: 1376504183
Provider Name (Legal Business Name): JAMES CARR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2006
Last Update Date: 06/24/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 E HURON ST FEINBERG 4-710
CHICAGO IL
60611-2908
US

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 312-926-5200
  • Fax: 312-926-0826
Mailing address:
  • Phone: 312-926-5200
  • Fax: 312-926-0826

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number036105524
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: