Healthcare Provider Details

I. General information

NPI: 1861456022
Provider Name (Legal Business Name): STEVEN CHAROUS M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 11/27/2023
Certification Date: 10/26/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3633 W LAKE AVE SUITE 300
GLENVIEW IL
60026-5805
US

IV. Provider business mailing address

3633 W LAKE AVE SUITE 300
GLENVIEW IL
60026-5805
US

V. Phone/Fax

Practice location:
  • Phone: 847-729-9122
  • Fax: 847-729-9134
Mailing address:
  • Phone: 847-729-9122
  • Fax: 847-729-9134

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number036084409
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: