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General NPI Number Information
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NPI Number | 1821362393
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Entity Type | Organization
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Legal Business Name | S T CEASAR MD SC
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Dates
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Enumeration Date | 03/01/2012
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Last Update Date | 03/01/2012
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Provider Practice Location Address
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Address Line | 231 E. 75TH STREET
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City | CHICAGO
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State | IL
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Zip | 60619-2267
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Country | US
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Telephone | 773-846-1200
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Fax |
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Provider Business Mailing Address
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Address Line | 231 E. 75TH STREET
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City | CHICAGO
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State | IL
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Zip | 60619-2267
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Country | US
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Telephone | 773-846-1200
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Fax |
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | DR. SHELDON T CEASER
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Credential | M.D.
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Telephone | 773-846-1200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036068033
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License Number State | IL
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