Healthcare Provider Details

I. General information

NPI: 1407845019
Provider Name (Legal Business Name): PULMONARY AND CRITICAL CARE CONSULTANTS, S.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 07/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11900 SOUTHWEST HWY
PALOS PARK IL
60464-1200
US

IV. Provider business mailing address

700 E OGDEN AVE STE 304
WESTMONT IL
60559-5554
US

V. Phone/Fax

Practice location:
  • Phone: 708-274-4900
  • Fax: 708-274-4949
Mailing address:
  • Phone: 866-871-5737
  • Fax: 630-522-0843

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207RS0012X
TaxonomySleep Medicine (Internal Medicine) Physician
License Number
License Number StateIL

VIII. Authorized Official

Name: DR. ANTANAS G RAZMA
Title or Position: OFFICER
Credential: MD
Phone: 708-274-4900