MEDICARE: STEVEN POTTS DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	036076672	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	31604381	OTHER	IL	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1033196688
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN POTTS DO

Provider Business Mailing Address
First Line	:	201 E HURON ST
Second Line	:	#11-230
City	:	CHICAGO
State	:	IL
Zip	:	60611-3197
Country	:	US
Telephone Number	:	312-642-6868
Fax Number	:	312-642-2902

Provider Business Practice Location Address
First Line	:	201 E HURON ST
Second Line	:	#11-230
City	:	CHICAGO
State	:	IL
Zip	:	60611-3197
Country	:	US
Telephone Number	:	312-642-6868
Fax Number	:	312-642-2902

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/26/2005
Last Update Date	:	04/20/2022

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Directions to “ STEVEN POTTS DO” Practice Location

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