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General NPI Number Information
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NPI Number | 1508221474
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Entity Type | Individual
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Provider Name | DAVID W TEEGARDEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/21/2015
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Last Update Date | 02/24/2024
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Provider Practice Location Address
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Address Line | 7531 S STONY ISLAND AVE JACKSON PARK HOSPITAL & MEDICAL CENTER
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City | CHICAGO
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State | IL
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Zip | 60649-3954
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Country | US
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Telephone | 844-596-0406
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Fax |
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Provider Business Mailing Address
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Address Line | 10155 S M 43 HWY UNIT 372
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City | DELTON
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State | MI
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Zip | 49046-9602
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Country | US
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Telephone | 269-282-9022
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Fax | 844-596-0406
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | BES5456LK
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License Number State | ZZ
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Taxonomy #2
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Taxonomy Code | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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License Number | 98912014BES
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License Number State | ZZ
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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