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NPI Code Detail

MEDICARE: JOEL SPEAR MD

MEDICARE: JOEL SPEAR 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
1207RI0200XInfectious Disease Physician036070345IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1440000197OTHERILRAIL ROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
21618792OTHERILBCBS PROVIDER ID
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679569859
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL SPEAR MD
Provider Business Mailing Address
First Line : 777 OAKMONT LN
Second Line : SUITE 1600
City : WESTMONT
State : IL
Zip : 60559-5511
Country : US
Telephone Number : 630-789-2550
Fax Number :
Provider Business Practice Location Address
First Line : 2900 N LAKE SHORE DR
Second Line : #1231
City : CHICAGO
State : IL
Zip : 60657-5640
Country : US
Telephone Number : 773-665-3261
Fax Number : 773-665-9435
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/23/2005
Last Update Date : 02/05/2013

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