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General NPI Number Information
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NPI Number | 1437315116
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Entity Type | Individual
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Provider Name | EDWARD WARREN PIROK III M.D., PH.D.
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Gender | Male
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Dates
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Enumeration Date | 08/01/2008
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Last Update Date | 02/17/2010
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Provider Practice Location Address
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Address Line | 446 E ONTARIO ST SUITE 6-300
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City | CHICAGO
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State | IL
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Zip | 60611-4418
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Country | US
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Telephone | 312-926-8200
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Fax |
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Provider Business Mailing Address
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Address Line | 737 N MICHIGAN AVE SUITE 2240
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City | CHICAGO
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State | IL
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Zip | 60611-2615
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Country | US
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Telephone | 312-291-4275
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 125063280
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License Number State | IL
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