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NPI Code Detail

MEDICARE: DR. JOSEPH SIEVE DETERS M.D.

MEDICARE: DR. JOSEPH SIEVE DETERS M.D.
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
1207R00000XInternal Medicine Physician036146227IL
2207RC0200XCritical Care Medicine (Internal Medicine) Physician036146227IL
3207RP1001XPulmonary Disease Physician036146227IL

General Provider Information

NPI Number : 1205217825
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JOSEPH SIEVE DETERS M.D.
Provider Business Mailing Address
First Line : 676 N SAINT CLAIR ST STE 14TH
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2927
Country : US
Telephone Number : 513-609-6660
Fax Number :
Provider Business Practice Location Address
First Line : 676 N SAINT CLAIR ST FL 14
Second Line :
City : CHICAGO
State : IL
Zip : 60611-2951
Country : US
Telephone Number : 312-926-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/10/2015
Last Update Date : 05/05/2021

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