Healthcare Provider Details
I. General information
NPI: 1659930998
Provider Name (Legal Business Name): HOWARD SIMON MD PLLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/11/2019
Last Update Date: 08/06/2025
Certification Date: 08/06/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
446 E ONTARIO ST STE 106
CHICAGO IL
60611-7110
US
IV. Provider business mailing address
16220 N SCOTTSDALE RD STE 600
SCOTTSDALE AZ
85254-1804
US
V. Phone/Fax
- Phone: 312-440-0016
- Fax:
- Phone: 480-306-6949
- Fax: 602-302-5706
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
HOWARD
J
SIMON
Title or Position: CEO
Credential: MD
Phone: 480-306-6949