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NPI Code Detail

MEDICARE: DR. MICHAEL A GREENBERG M.D.

MEDICARE:  DR. MICHAEL A GREENBERG  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
1207N00000XDermatology Physician036-051235IL
2207NS0135XProcedural Dermatology Physician036-051235IL

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1791073085OTHERILRAILROAD MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
221607262OTHERILBLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1891788105
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL A GREENBERG M.D.
Provider Business Mailing Address
First Line : 800 BIESTERFIELD RD
Second Line : STE 3002
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-3364
Country : US
Telephone Number : 847-364-4717
Fax Number : 847-364-0191
Provider Business Practice Location Address
First Line : 800 BIESTERFIELD RD
Second Line : STE 3002
City : ELK GROVE VILLAGE
State : IL
Zip : 60007-3364
Country : US
Telephone Number : 847-364-4717
Fax Number : 847-364-0191
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/23/2005
Last Update Date : 09/12/2012

Similar Medicare Providers

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Practice Location Address:
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1487836078 — DR. MAUREEN ELIZABETH HENDRON M.D.
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Directions to “ DR. MICHAEL A GREENBERG M.D.” Practice Location

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