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General NPI Number Information
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NPI Number | 1417072943
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Entity Type | Organization
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Legal Business Name | EMERGENCY TREATMENT, S.C.
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Dates
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Enumeration Date | 03/21/2007
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Last Update Date | 07/10/2007
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Provider Practice Location Address
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Address Line | 2000 OGDEN AVE
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City | AURORA
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State | IL
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Zip | 60504-7222
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Country | US
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Telephone | 630-978-4810
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Fax | 630-978-6802
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Provider Business Mailing Address
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Address Line | 2142 N SEDGWICK ST
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City | CHICAGO
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State | IL
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Zip | 60614-4620
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Country | US
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Telephone | 773-327-0777
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARSHALL B. SEGAL
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Credential | M.D.
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Telephone | 773-327-0777
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number |
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License Number State | IL
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