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General NPI Number Information
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NPI Number | 1013010487
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Entity Type | Individual
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Provider Name | CELALETTIN USTUN MD
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Gender | Male
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Dates
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Enumeration Date | 09/07/2006
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Last Update Date | 09/21/2018
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Provider Practice Location Address
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Address Line | 1725 W HARRISON ST STE 1010
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City | CHICAGO
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State | IL
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Zip | 60612
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Country | US
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Telephone | 312-942-5904
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Fax | 312-942-3194
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Provider Business Mailing Address
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Address Line | 1725 W HARRISON ST STE 1010
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City | CHICAGO
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State | IL
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Zip | 60612-3841
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Country | US
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Telephone | 312-942-5904
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Fax | 312-942-3194
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 036-147386
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License Number State | IL
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