MEDICARE: DR. DAVID MARC CIVITARESE 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	125.077388	IL
2	208100000X	Physical Medicine & Rehabilitation Physician	125.077388	IL
3	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1063048676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID MARC CIVITARESE DO

Provider Business Mailing Address
First Line	:	420 E SUPERIOR ST STE 9-900
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4494
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 E SUPERIOR ST STE 9-900
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611-4494
Country	:	US
Telephone Number	:	312-503-7975
Fax Number	:

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

Provider Enumeration Date	:	03/14/2020
Last Update Date	:	12/16/2025

Similar Medicare Providers

1730798034 — NADIA RAE SION MD
Practice Location Address:

420 E SUPERIOR ST STE 9-900
CHICAGO, IL
60611-4494

Practice Phone: 312-503-7975
Practice Fax:

1760703771 — MATTHEW STEVEN PATTON M.D.
Practice Location Address:

420 E SUPERIOR ST , RUBLOFF BUILDING, 12TH FLOOR
CHICAGO, IL
60611-4494

Practice Phone: 312-694-7000
Practice Fax:

1821319419 — DR. BETH DUNLAP MD
Practice Location Address:

420 E SUPERIOR ST , STE 12
CHICAGO, IL
60611-4494

Practice Phone: 312-503-7975
Practice Fax:

1104137231 — DR. RAVI RAJARAM M.D.
Practice Location Address:

420 E SUPERIOR ST , RUBLOFF 12TH FLOOR
CHICAGO, IL
60611-4494

Practice Phone: 312-503-7975
Practice Fax:

1245541374 — MR. MOR BEN BARAK M.D.
Practice Location Address:

420 E SUPERIOR ST FL 12
CHICAGO, IL
60611-4494

Practice Phone: 312-503-7975
Practice Fax:

1154639771 — PENG JI M.D., PH.D.
Practice Location Address:

420 E SUPERIOR ST , RUBLOFF BUILDING 12-172
CHICAGO, IL
60611-4494

Practice Phone: 312-503-4756
Practice Fax:

Directions to “ DR. DAVID MARC CIVITARESE DO” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.