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NPI Code Detail

MEDICARE: CHICAGO INFECTIOUS DISEASES LLC

MEDICARE: CHICAGO INFECTIOUS DISEASES LLC
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
1207RI0200XInfectious Disease Physician

General Provider Information

NPI Number : 1184623548
Entity Type Code : Organization
Provider Name (Legal Business Name) : CHICAGO INFECTIOUS DISEASES LLC
Provider Business Mailing Address
First Line : 520 E 22ND ST
Second Line :
City : LOMBARD
State : IL
Zip : 60148-6110
Country : US
Telephone Number : 630-874-2542
Fax Number :
Provider Business Practice Location Address
First Line : 2929 S ELLIS AVE
Second Line :
City : CHICAGO
State : IL
Zip : 60616-3395
Country : US
Telephone Number : 312-791-2000
Fax Number :
Authorized Official
Title or Position : CHAIRMAN
Name : NICOLAS P. VOGEL
Credential : M.D.
Telephone Number : 312-791-2000
Provider Enumeration Date : 07/19/2005
Last Update Date : 11/26/2007

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Directions to “CHICAGO INFECTIOUS DISEASES LLC ” Practice Location

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