MEDICARE: CAN CAGLAR ERDEM 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
1	208G00000X	Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician	125071555	IL

General Provider Information

NPI Number	:	1942398789
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CAN CAGLAR ERDEM M.D.

Provider Business Mailing Address
First Line	:	1650 W HARRISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3800
Country	:	US
Telephone Number	:	312-942-1827
Fax Number	:

Provider Business Practice Location Address
First Line	:	1650 W HARRISON ST
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60612-3800
Country	:	US
Telephone Number	:	312-942-1827
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	07/21/2022

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