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NPI Code Detail

MEDICARE: EDWARD TUDER MD

MEDICARE:   EDWARD  TUDER  MD
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
12084P0800XPsychiatry PhysicianIL

General Provider Information

NPI Number : 1093989170
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD TUDER MD
Provider Business Mailing Address
First Line : 150 E HURON STREET
Second Line : SUITE 1306
City : CHICAGO
State : IL
Zip : 60611-2962
Country : US
Telephone Number : 312-943-0378
Fax Number : 312-943-9943
Provider Business Practice Location Address
First Line : 150 E HURON STREET
Second Line : SUITE 1306
City : CHICAGO
State : IL
Zip : 60611-2962
Country : US
Telephone Number : 312-943-0378
Fax Number : 312-943-9943
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/18/2008
Last Update Date : 04/18/2008

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Directions to “ EDWARD TUDER MD” Practice Location

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