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General NPI Number Information
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NPI Number | 1073595427
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Entity Type | Individual
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Provider Name | MICHAEL D CARRITHERS MD
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Gender | Male
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Dates
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Enumeration Date | 11/18/2005
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Last Update Date | 10/16/2023
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Provider Practice Location Address
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Address Line | 912 S WOOD STREET DEPARTMENT OF NEUROLOGY
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City | CHICAGO
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State | IL
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Zip | 60612-6061
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Country | US
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Telephone | 203-843-0770
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Fax |
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Provider Business Mailing Address
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Address Line | 912 S WOOD STREET DEPARTMENT OF NEUROLOGY
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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 | 203-843-0770
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Fax |
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 036.137738
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License Number State | IL
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