Healthcare Provider Details

I. General information

NPI: 1306114590
Provider Name (Legal Business Name): STEVEN D. FIELD, M.D. S. C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/02/2011
Last Update Date: 12/02/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

666 DUNDEE ROAD SUITE 1701
NORTHBROOK IL
60062-2738
US

IV. Provider business mailing address

666 DUNDEE ROAD SUITE 1701
NORTHBROOK IL
60062-2738
US

V. Phone/Fax

Practice location:
  • Phone: 847-564-5645
  • Fax: 847-564-7706
Mailing address:
  • Phone: 847-564-5645
  • Fax: 847-564-7706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number036-057386
License Number StateIL

VIII. Authorized Official

Name: DR. STEVEN DAVID FIELD
Title or Position: PRESIDENT
Credential: MD
Phone: 847-564-5645